# NIZHONI PROFESSIONAL HOME CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760612717
- **Authorized official:** MRS. THERESA MAE WARNER (PRESIDENT)
- **Authorized official phone:** (505) 863-9199

## Contact information

- **Practice address:** 1303 METRO DR, GALLUP, NM 87301
- **Practice address phone:** (505) 863-9199
- **Practice address fax:** (505) 863-9219
- **Mailing address:** 1303 METRO DR, GALLUP, NM 87301
- **Mailing address phone:** (505) 863-9199
- **Mailing address fax:** (505) 863-9219

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NM | Yes |

## Other

- **Enumeration date:** 07/23/2009
- **Last updated:** 07/23/2009