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NPI Code Detail

MEDICARE: MY FAMILY HOME

MEDICARE: MY FAMILY HOME
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
1305R00000XPreferred Provider OrganizationNV

General Provider Information

NPI Number : 1205183886
Entity Type Code : Organization
Provider Name (Legal Business Name) : MY FAMILY HOME
Provider Business Mailing Address
First Line : 2224 CANARY WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-1912
Country : US
Telephone Number : 702-201-8585
Fax Number :
Provider Business Practice Location Address
First Line : 2224 CANARY WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89106-1912
Country : US
Telephone Number : 702-201-8585
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MRS. JEWEL DEGUZMAN
Credential : OWNER
Telephone Number : 702-636-8762
Provider Enumeration Date : 08/13/2012
Last Update Date : 07/21/2022

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Directions to “MY FAMILY HOME ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.