Healthcare Provider Details

I. General information

NPI: 1396649562
Provider Name (Legal Business Name): NELSIES CARE HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5268 CASPIAN DR
LAS VEGAS NV
89118-1409
US

IV. Provider business mailing address

5268 CASPIAN DR
LAS VEGAS NV
89118-1409
US

V. Phone/Fax

Practice location:
  • Phone: 775-513-8648
  • Fax:
Mailing address:
  • Phone: 775-513-8648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: NELSIE MOOREHEAD
Title or Position: OWNER
Credential:
Phone: 775-513-8648