Healthcare Provider Details

I. General information

NPI: 1467315754
Provider Name (Legal Business Name): HEART WELL REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 W HORIZON RIDGE PKWY STE 100
HENDERSON NV
89052-5946
US

IV. Provider business mailing address

2475 W HORIZON RIDGE PKWY STE 100
HENDERSON NV
89052-5946
US

V. Phone/Fax

Practice location:
  • Phone: 877-478-9355
  • Fax:
Mailing address:
  • Phone: 877-478-9355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0404X
TaxonomyCardiac Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163WC3500X
TaxonomyCardiac Rehabilitation Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: VEA EVANGELISTA
Title or Position: DIRECTOR
Credential:
Phone: 646-639-3411