Healthcare Provider Details

I. General information

NPI: 1083367809
Provider Name (Legal Business Name): LAS VEGAS FAMILY HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 E SAHARA AVE STE 4A
LAS VEGAS NV
89104-3495
US

IV. Provider business mailing address

1650 E SAHARA AVE STE 4A
LAS VEGAS NV
89104-3495
US

V. Phone/Fax

Practice location:
  • Phone: 702-769-0584
  • Fax:
Mailing address:
  • Phone: 702-769-0584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MAIDELYN DE LA PAZ
Title or Position: ADMINITRATOR
Credential:
Phone: 702-769-0584