# RADIANT HOME HEALTH CARE LLC

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

## Provider details

- **NPI number:** 1861891269
- **Authorized official:** DERRICK BONNEY RN (CEO/AGENCY PROGRAM DIRECTOR)
- **Authorized official phone:** (505) 722-9951

## Contact information

- **Practice address:** 1210 E HIGHWAY 66, GALLUP, NM 87301-4993
- **Practice address phone:** (505) 722-9951
- **Practice address fax:** (505) 722-9952
- **Mailing address:** 1210 E HIGHWAY 66, GALLUP, NM 87301-4993
- **Mailing address phone:** (505) 722-9951
- **Mailing address fax:** (505) 722-9952

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 251J00000X | Nursing Care Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |

## Other

- **Enumeration date:** 08/21/2014
- **Last updated:** 01/30/2024