MEDICARE: ENERGEN HOME HEALTH 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1437958741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENERGEN HOME HEALTH CARE

Provider Business Mailing Address
First Line	:	4045 SPENCER ST STE 210
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5247
Country	:	US
Telephone Number	:	702-956-7877
Fax Number	:

Provider Business Practice Location Address
First Line	:	4045 SPENCER ST STE 210
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5247
Country	:	US
Telephone Number	:	702-956-7877
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	TRISTIN TAYLOR PRICE
Credential	:
Telephone Number	:	702-956-7877

Provider Enumeration Date	:	03/10/2025
Last Update Date	:	03/10/2025

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Directions to “ENERGEN HOME HEALTH CARE ” Practice Location

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