Healthcare Provider Details

I. General information

NPI: 1700238664
Provider Name (Legal Business Name): HARBOR HOSPICE OF LAS VEGAS LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2016
Last Update Date: 04/13/2021
Certification Date: 04/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5575 S DURANGO DR STE 105
LAS VEGAS NV
89113-1834
US

IV. Provider business mailing address

3406 COLLEGE ST STE 200
BEAUMONT TX
77701-4612
US

V. Phone/Fax

Practice location:
  • Phone: 702-541-6273
  • Fax: 702-541-8268
Mailing address:
  • Phone: 409-730-2022
  • Fax: 409-232-0573

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: KAREN K CARTER
Title or Position: EXEC ADMIN ASST
Credential:
Phone: 409-730-2046