MEDICARE: ADVISACARE SOLUTIONS OF NEVADA, INC.

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		NV

General Provider Information

NPI Number	:	1619360740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVISACARE SOLUTIONS OF NEVADA, INC.

Provider Business Mailing Address
First Line	:	1840 E WARM SPRINGS RD
Second Line	:	STE. 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4523
Country	:	US
Telephone Number	:	702-896-6393
Fax Number	:

Provider Business Practice Location Address
First Line	:	1840 E WARM SPRINGS RD
Second Line	:	STE. 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4523
Country	:	US
Telephone Number	:	702-896-6393
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KRIS SKOGEN
Credential	:
Telephone Number	:	616-464-1117

Provider Enumeration Date	:	03/13/2015
Last Update Date	:	03/13/2015

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