1720290653 NPI number — LIFE CARE HOME HEALTH INC

Table of content: WILLIAM ELWOOD HABLITZEL M.D. (NPI 1356393201)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720290653 NPI number — LIFE CARE HOME HEALTH INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIFE CARE HOME HEALTH 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:
1720290653
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3017 W CHARLESTON BLVD STE 15
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:
89102-1927
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-363-9775
Provider Business Mailing Address Fax Number:
702-363-9776

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3017 W CHARLESTON BLVD STE 15
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:
89102-1927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-363-9775
Provider Business Practice Location Address Fax Number:
702-363-9776
Provider Enumeration Date:
05/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CABRERA
Authorized Official First Name:
BENEDICK
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSISTANT ADMINISTRATOR
Authorized Official Telephone Number:
702-363-9775

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  4603HHA-0 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4603HHA-0 . This is a "STATE LICENSE NUMBER" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com