Provider Demographics
NPI:1184979163
Name:NATIVE AMERICAN HOME CARE LLC
Entity type:Organization
Organization Name:NATIVE AMERICAN HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:CORTEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-371-5141
Mailing Address - Street 1:PO BOX 3107
Mailing Address - Street 2:
Mailing Address - City:WINDOW ROCK
Mailing Address - State:AZ
Mailing Address - Zip Code:86515-3107
Mailing Address - Country:US
Mailing Address - Phone:505-371-5141
Mailing Address - Fax:505-371-5861
Practice Address - Street 1:JD MOBILE HOME PARK #15
Practice Address - Street 2:
Practice Address - City:TSE BONITO
Practice Address - State:NM
Practice Address - Zip Code:87301
Practice Address - Country:US
Practice Address - Phone:505-371-5141
Practice Address - Fax:505-371-5861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health