Healthcare Provider Details

I. General information

NPI: 1275953226
Provider Name (Legal Business Name): HEALTH & CARE PROFESSIONAL NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2014
Last Update Date: 05/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4535 W SAHARA AVE 100B
LAS VEGAS NV
89102-3625
US

IV. Provider business mailing address

4535 W SAHARA AVE 100B
LAS VEGAS NV
89102-3625
US

V. Phone/Fax

Practice location:
  • Phone: 702-871-9917
  • Fax:
Mailing address:
  • Phone: 702-871-9917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number7872PCS-0
License Number StateNV

VIII. Authorized Official

Name: MR. GEMMA VIRAY
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 702-871-9917