Healthcare Provider Details

I. General information

NPI: 1225885221
Provider Name (Legal Business Name): WARM HEARTS HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3434 GOSLING ST
LAS VEGAS NV
89117-8418
US

IV. Provider business mailing address

3434 GOSLING ST
LAS VEGAS NV
89117-8418
US

V. Phone/Fax

Practice location:
  • Phone: 702-810-0393
  • Fax:
Mailing address:
  • Phone: 702-810-0393
  • 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 Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: KADIN BOUDAGHIAN
Title or Position: OWNER
Credential:
Phone: 702-810-0393