MEDICARE: COMPASSIONATE CARE HOME 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	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1497609572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPASSIONATE CARE HOME LLC

Provider Business Mailing Address
First Line	:	1680 SOMBRERO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-2564
Country	:	US
Telephone Number	:	702-209-2580
Fax Number	:	702-446-8134

Provider Business Practice Location Address
First Line	:	1680 SOMBRERO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-2564
Country	:	US
Telephone Number	:	702-209-2580
Fax Number	:	702-446-8134

Authorized Official
Title or Position	:	MANAGER
Name	:	CHRISTOPHER DIAZ
Credential	:	RN
Telephone Number	:	702-209-2580

Provider Enumeration Date	:	02/24/2026
Last Update Date	:	02/24/2026

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