Healthcare Provider Details

I. General information

NPI: 1790286151
Provider Name (Legal Business Name): GIFTED UNITY LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2018
Last Update Date: 09/07/2021
Certification Date: 09/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 S WATER ST STE B
HENDERSON NV
89015-5039
US

IV. Provider business mailing address

331 S WATER ST STE B
HENDERSON NV
89015-5039
US

V. Phone/Fax

Practice location:
  • Phone: 702-761-1850
  • Fax:
Mailing address:
  • Phone: 702-761-1850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: TIECHAYE C CULVER
Title or Position: ADMINISTRATOR
Credential: LPN
Phone: 702-761-1850