Healthcare Provider Details

I. General information

NPI: 1144885633
Provider Name (Legal Business Name): SCHMIDT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3365 WYNN RD STE B
LAS VEGAS NV
89102-8202
US

IV. Provider business mailing address

3365 WYNN RD STE B
LAS VEGAS NV
89102-8202
US

V. Phone/Fax

Practice location:
  • Phone: 702-986-8514
  • Fax:
Mailing address:
  • Phone: 702-986-8514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANA BAILETTI
Title or Position: ASSISTANT ADMINISTRATOR
Credential:
Phone: 702-331-4161