Healthcare Provider Details

I. General information

NPI: 1376086678
Provider Name (Legal Business Name): ALFA HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2016
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 E SAHARA AVE STE J
LAS VEGAS NV
89104-3491
US

IV. Provider business mailing address

1640 E SAHARA AVE STE J
LAS VEGAS NV
89104-3491
US

V. Phone/Fax

Practice location:
  • Phone: 702-776-1004
  • Fax:
Mailing address:
  • Phone: 702-776-1004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number8646-PCS-0
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: CLAUDIA Y NUNEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 702-776-1004