Organization
RADIANT HOME HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK BONNEY (DIRECTOR)
(505) 722-9951
Entity
Organization
Contact information
Practice address
101 S CLARK ST, GALLUP, NM 87301-6678
(505) 722-9951
Mailing address
101 S CLARK ST, GALLUP, NM 87301-6678
(505) 722-9951
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/03/2021
Last updated
11/03/2021
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