MEDICARE: COMPREHENSIVE HEALTH SERVICE 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	251E00000X	Home Health Agency

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	:	1811322357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE HEALTH SERVICE LLC

Provider Business Mailing Address
First Line	:	2330 PASEO DEL PRADO
Second Line	:	SUITE C308
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-4359
Country	:	US
Telephone Number	:	702-489-9355
Fax Number	:	702-413-6333

Provider Business Practice Location Address
First Line	:	2330 PASEO DEL PRADO STE C202
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-4376
Country	:	US
Telephone Number	:	702-489-9355
Fax Number	:	702-413-6333

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DEMETRIO ENCABO JR.
Credential	:
Telephone Number	:	702-489-9355

Provider Enumeration Date	:	09/03/2013
Last Update Date	:	10/15/2020

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