Healthcare Provider Details

I. General information

NPI: 1205188745
Provider Name (Legal Business Name): PROGRESSIVE HOME HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2012
Last Update Date: 10/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4535 W SAHARA AVE STE 115
LAS VEGAS NV
89102-3708
US

IV. Provider business mailing address

4535 W SAHARA AVE STE 115
LAS VEGAS NV
89102-3708
US

V. Phone/Fax

Practice location:
  • Phone: 702-778-1188
  • Fax: 702-778-8180
Mailing address:
  • Phone: 702-778-1188
  • Fax: 702-778-8180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ALAN JAUREGUI
Title or Position: PRESIDENT
Credential: MD, APN, FNP, MSN
Phone: 702-266-7277