Provider Demographics
NPI:1750407961
Name:SHANDIIN HOME CARE
Entity type:Organization
Organization Name:SHANDIIN HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-488-5437
Mailing Address - Street 1:PO BOX 971
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NM
Mailing Address - Zip Code:87347-0971
Mailing Address - Country:US
Mailing Address - Phone:505-488-5437
Mailing Address - Fax:505-488-5437
Practice Address - Street 1:WEST BLUE CEDAR LOOP
Practice Address - Street 2:#2
Practice Address - City:JAMESTOWN
Practice Address - State:NM
Practice Address - Zip Code:87347-0971
Practice Address - Country:US
Practice Address - Phone:505-488-5437
Practice Address - Fax:505-488-5437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM47721804251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health