1326559345 NPI number — LAS VEGAS HEALTH CARE,LLC LIMITED LIABILITY COMPANY

Table of content: (NPI 1326559345)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326559345 NPI number — LAS VEGAS HEALTH CARE,LLC LIMITED LIABILITY COMPANY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAS VEGAS HEALTH CARE,LLC LIMITED LIABILITY COMPANY
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:
HOME HEALTH CARE
Provider Other Organization Name Type Code:
5
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:
1326559345
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6290 S RAINBOW BLVD STE 9
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:
89118-3246
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-410-8018
Provider Business Mailing Address Fax Number:
702-410-8018

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6290 S RAINBOW BLVD STE 9
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:
89118-3246
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-410-8018
Provider Business Practice Location Address Fax Number:
702-410-8018
Provider Enumeration Date:
10/17/2017

Additional Information

Authorized Official

Authorized Official Last Name:
WAHAB
Authorized Official First Name:
SHARIFA
Authorized Official Middle Name:
G
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
702-234-9088

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X , 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)





Copyright © 2007-2024 www.npivalidator.com