Healthcare Provider Details

I. General information

NPI: 1891356770
Provider Name (Legal Business Name): ANCHOR HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2019
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 WINWOOD ST
LAS VEGAS NV
89108-1575
US

IV. Provider business mailing address

3151 SOARING GULLS DR UNIT 2058
LAS VEGAS NV
89128-7037
US

V. Phone/Fax

Practice location:
  • Phone: 702-686-4698
  • Fax:
Mailing address:
  • Phone: 702-686-4698
  • 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

VIII. Authorized Official

Name: HEATHER ANN MADISON
Title or Position: OWNER
Credential: PCA
Phone: 702-686-4698