Provider Demographics
NPI:1457098444
Name:SAFARI HEALTH CARE LLC
Entity Type:Organization
Organization Name:SAFARI HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:GACHUMA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:508-769-4095
Mailing Address - Street 1:3937 SPENCER ST APT 199
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5217
Mailing Address - Country:US
Mailing Address - Phone:702-690-3019
Mailing Address - Fax:702-847-8832
Practice Address - Street 1:2350 S JONES BLVD # D5
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-3103
Practice Address - Country:US
Practice Address - Phone:702-690-3019
Practice Address - Fax:702-847-8832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health