Healthcare Provider Details

I. General information

NPI: 1790421410
Provider Name (Legal Business Name): ZINNIA HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2022
Last Update Date: 05/05/2022
Certification Date: 09/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7125 GRAND MONTECITO PKWY STE 110
LAS VEGAS NV
89149-0261
US

IV. Provider business mailing address

9811 W CHARLESTON BLVD # 2-859
LAS VEGAS NV
89117-7528
US

V. Phone/Fax

Practice location:
  • Phone: 725-266-5386
  • Fax:
Mailing address:
  • Phone: 725-266-5386
  • 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: ERIC JAYSON ZANG
Title or Position: OWNER
Credential:
Phone: 725-266-5386