1962085068 NPI number — CAREPOINTE HOME HEALTH SERVICES LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962085068 NPI number — CAREPOINTE HOME HEALTH SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAREPOINTE HOME HEALTH SERVICES LLC
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:
1962085068
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/12/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10029 MADISON WALK AVE
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:
89149-3771
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-899-8040
Provider Business Mailing Address Fax Number:
702-946-0406

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2620 REGATTA DR
Provider Second Line Business Practice Location Address:
STE 102 #239
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89128-6892
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-899-8040
Provider Business Practice Location Address Fax Number:
702-946-0406
Provider Enumeration Date:
05/05/2021

Additional Information

Authorized Official

Authorized Official Last Name:
WATSON
Authorized Official First Name:
MONTEKO
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/ADMINISTRATOR
Authorized Official Telephone Number:
716-247-0952

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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