MEDICARE: SMILE HOME HEALTH 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1275331449
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMILE HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	3202 W CHARLESTON BLVD UNIT 3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1932
Country	:	US
Telephone Number	:	725-726-6655
Fax Number	:	725-726-6644

Provider Business Practice Location Address
First Line	:	3202 W CHARLESTON BLVD UNIT 3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1932
Country	:	US
Telephone Number	:	725-726-6655
Fax Number	:	725-726-6644

Authorized Official
Title or Position	:	CEO
Name	:	MARINA PARUNASHVILI
Credential	:
Telephone Number	:	725-726-6655

Provider Enumeration Date	:	03/04/2025
Last Update Date	:	03/04/2025

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Directions to “SMILE HOME HEALTH LLC ” Practice Location

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