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NPI Code Detail

MEDICARE: HOMETRUST HEALTHCARE, LLC

MEDICARE: HOMETRUST HEALTHCARE, 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
1253Z00000XIn Home Supportive Care Agency7627PCS-0NV

General Provider Information

NPI Number : 1922440924
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOMETRUST HEALTHCARE, LLC
Provider Business Mailing Address
First Line : 4535 W SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-3625
Country : US
Telephone Number : 702-948-8919
Fax Number : 702-413-7701
Provider Business Practice Location Address
First Line : 4535 W SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-3625
Country : US
Telephone Number : 702-948-8919
Fax Number : 702-413-7701
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. CECILIA CALLAO LABINPUNO
Credential : LPN
Telephone Number : 702-948-8919
Provider Enumeration Date : 07/19/2013
Last Update Date : 07/19/2013

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Directions to “HOMETRUST HEALTHCARE, LLC ” Practice Location

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