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Organization
RADIANT HOME HEALTH CARE LLC
Active
Organization
RADIANT HOME HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK BONNEY RN (CEO/AGENCY PROGRAM DIRECTOR)
(505) 722-9951
Entity
Organization
Contact information
Practice address
1210 E HIGHWAY 66, GALLUP, NM 87301-4993
(505) 722-9951
(505) 722-9952
Mailing address
1210 E HIGHWAY 66, GALLUP, NM 87301-4993
(505) 722-9951
(505) 722-9952
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
251J00000X
Nursing Care Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
Other
Enumeration date
08/21/2014
Last updated
01/30/2024
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