Healthcare Provider Details

I. General information

NPI: 1104680727
Provider Name (Legal Business Name): RED ROCK HOME HEALTH CARE CORPORARTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2024
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 REGATTA DR STE 126
LAS VEGAS NV
89128-6891
US

IV. Provider business mailing address

7040 LAREDO ST STE E
LAS VEGAS NV
89117-3044
US

V. Phone/Fax

Practice location:
  • Phone: 702-488-2838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: K C
Title or Position: PRESIDENT
Credential:
Phone: 702-488-2838