1043419344 NPI number — NEVADA HOME HEALTH PROVIDERS, INC.

Table of content: (NPI 1043419344)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043419344 NPI number — NEVADA HOME HEALTH PROVIDERS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEVADA HOME HEALTH PROVIDERS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043419344
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1210 S VALLEY VIEW BLVD STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89102-1857
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-382-8331
Provider Business Mailing Address Fax Number:
702-382-9346

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1210 S VALLEY VIEW BLVD STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89102-1857
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-382-8331
Provider Business Practice Location Address Fax Number:
702-382-9346
Provider Enumeration Date:
07/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DUNKELMAN-FARAON
Authorized Official First Name:
LORILYN
Authorized Official Middle Name:
T.
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
702-382-8331

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  4091HHA-2 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251E00000X , with the licence number: 5579HHA-9 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100512595 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".




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