Healthcare Provider Details

I. General information

NPI: 1689336877
Provider Name (Legal Business Name): KANDELL HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2021
Last Update Date: 09/06/2023
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1771 E FLAMINGO RD STE 215B
LAS VEGAS NV
89119-5154
US

IV. Provider business mailing address

1771 E FLAMINGO RD STE 215B
LAS VEGAS NV
89119-5154
US

V. Phone/Fax

Practice location:
  • Phone: 702-834-9260
  • Fax: 702-337-2027
Mailing address:
  • Phone: 702-834-9260
  • Fax: 702-337-2027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State
# 9
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RONALD ERIC KANDELL
Title or Position: OWNER
Credential:
Phone: 702-834-9260