Healthcare Provider Details

I. General information

NPI: 1124360052
Provider Name (Legal Business Name): 247 HOSPICE LAS VEGAS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2013
Last Update Date: 04/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3651 LINDELL RD STE K
LAS VEGAS NV
89103-1254
US

IV. Provider business mailing address

16027 BROOKHURST ST I-341
FOUNTAIN VALLEY CA
92708-1551
US

V. Phone/Fax

Practice location:
  • Phone: 702-297-8888
  • Fax: 702-988-8813
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: GINA CASTROMAYOR
Title or Position: ADMINISTRATOR/DPCS
Credential: RN
Phone: 702-297-8888