Provider Demographics
NPI:1205451887
Name:HANDSON HOME CARE
Entity type:Organization
Organization Name:HANDSON HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:JAWONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-350-1676
Mailing Address - Street 1:352 PEACEFUL MEADOWS DR NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-4102
Mailing Address - Country:US
Mailing Address - Phone:505-350-1676
Mailing Address - Fax:505-892-5009
Practice Address - Street 1:352 PEACEFUL MEADOWS DR NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-4102
Practice Address - Country:US
Practice Address - Phone:505-350-1676
Practice Address - Fax:505-892-5009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health