Organization
FOUR SEASONS HOME HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIVIAN BENALLY (CEO/ OWNER)
(505) 635-3071
Entity
Organization
Contact information
Practice address
64 W DINE HOUSING ST LOT 12, SHIPROCK, NM 87420
(505) 635-3071
Mailing address
PO BOX 53, SHIPROCK, NM 87420-0053
(505) 635-3071
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
101883
NM
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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