Healthcare Provider Details

I. General information

NPI: 1366977696
Provider Name (Legal Business Name): NELLIS HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2017
Last Update Date: 04/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 E TWAIN AVE # 103
LAS VEGAS NV
89169-4928
US

IV. Provider business mailing address

455 E TWAIN AVE # 103
LAS VEGAS NV
89169-4928
US

V. Phone/Fax

Practice location:
  • Phone: 702-401-1121
  • Fax: 702-733-2897
Mailing address:
  • Phone: 702-401-1121
  • Fax: 702-733-2897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License NumberE0308632016-8
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberE0308632016-8
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberE0308632016-8
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberE0308632016-8
License Number StateNV
# 5
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberE0308632016-8
License Number StateNV
# 6
Primary TaxonomyN
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License NumberE0308632016-8
License Number StateNV
# 7
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License NumberE0308632016-8
License Number StateNV
# 8
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberE0308632016-8
License Number StateNV
# 9
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License NumberE0308632016-8
License Number StateNV
# 10
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberE0308632016-8
License Number StateNV
# 11
Primary TaxonomyN
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License NumberE0308632016-8
License Number StateNV
# 12
Primary TaxonomyN
Taxonomy Code2865X1600X
TaxonomyOperational (Transportable) Military General Acute Care Hospital
License NumberE0308632016-8
License Number StateNV
# 13
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License NumberE0308632016-8
License Number StateNV
# 14
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberE0308632016-8
License Number StateNV
# 15
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberE0308632016-8
License Number StateNV

VIII. Authorized Official

Name: MS. ROSEANNE WRIGHT JONES
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 702-401-1121