1487165684 NPI number — AMBER CARE HOSPICE, INC

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 1487165684 NPI number — AMBER CARE HOSPICE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMBER CARE HOSPICE, 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:
1487165684
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6655 W. SAHARA AVE
Provider Second Line Business Mailing Address:
B-108
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89146
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-476-3350
Provider Business Mailing Address Fax Number:
702-476-4937

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6655 W. SAHARA AVE
Provider Second Line Business Practice Location Address:
B-108
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89146
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-476-3350
Provider Business Practice Location Address Fax Number:
702-476-4937
Provider Enumeration Date:
10/16/2017

Additional Information

Authorized Official

Authorized Official Last Name:
ESTACIO
Authorized Official First Name:
CATHRINA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
702-476-4937

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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