MEDICARE: LAS VEGAS SOLARI HOSPICE CARE 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	251G00000X	Community Based Hospice Care Agency		NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750328589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAS VEGAS SOLARI HOSPICE CARE LLC

Provider Business Mailing Address
First Line	:	700 E WARM SPRINGS RD
Second Line	:	#300
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4305
Country	:	US
Telephone Number	:	702-216-3346
Fax Number	:	702-671-6883

Provider Business Practice Location Address
First Line	:	5550 S JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-0566
Country	:	US
Telephone Number	:	702-870-0000
Fax Number	:	702-870-9500

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DENNIS KOGOOD
Credential	:
Telephone Number	:	702-932-8555

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	05/31/2016

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