Provider Demographics
NPI:1366279705
Name:SAFARI HEALTHCARE FOUNDATION
Entity type:Organization
Organization Name:SAFARI HEALTHCARE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:JUMA
Authorized Official - Last Name:KAP KIRWOK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:616-566-3803
Mailing Address - Street 1:2406 WILDWIND RD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88007-5503
Mailing Address - Country:US
Mailing Address - Phone:616-566-3803
Mailing Address - Fax:
Practice Address - Street 1:735 S MESQUITE ST
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-3622
Practice Address - Country:US
Practice Address - Phone:800-831-5105
Practice Address - Fax:800-831-5105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty