MEDICARE: TIME FOR LIFE HOME CARE

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	302F00000X	Exclusive Provider Organization	E0161612016-9	NV

General Provider Information

NPI Number	:	1427403310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIME FOR LIFE HOME CARE

Provider Business Mailing Address
First Line	:	6032 TERSKY CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89122-3443
Country	:	US
Telephone Number	:	702-601-9381
Fax Number	:

Provider Business Practice Location Address
First Line	:	6032 TERSKY CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89122-3443
Country	:	US
Telephone Number	:	702-601-9381
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. THIERRY DIEZ
Credential	:
Telephone Number	:	702-601-9381

Provider Enumeration Date	:	04/28/2016
Last Update Date	:	08/19/2016

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Directions to “TIME FOR LIFE HOME CARE ” Practice Location

Language	Start Address	Practice Location

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