MEDICARE: LOVING HANDS OF NEVADA HOME HEALTH CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114429115
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVING HANDS OF NEVADA HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	153 W LAKE MEAD PKWY STE 2240
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-8004
Country	:	US
Telephone Number	:	702-566-2433
Fax Number	:	702-565-2600

Provider Business Practice Location Address
First Line	:	153 W LAKE MEAD PKWY STE 2240
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-8004
Country	:	US
Telephone Number	:	702-566-2433
Fax Number	:	702-565-2600

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BERLINDA VALLEJOS
Credential	:
Telephone Number	:	702-566-2433

Provider Enumeration Date	:	03/06/2018
Last Update Date	:	03/06/2018

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