Healthcare Provider Details

I. General information

NPI: 1073185534
Provider Name (Legal Business Name): ATEVAN HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 07/14/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 S JONES BLVD STE G
LAS VEGAS NV
89146-3165
US

IV. Provider business mailing address

2001 S JONES BLVD STE G
LAS VEGAS NV
89146-3165
US

V. Phone/Fax

Practice location:
  • Phone: 702-545-0477
  • Fax:
Mailing address:
  • Phone: 702-545-0477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PAOLA NAVA
Title or Position: ADMINISTRATOR
Credential:
Phone: 702-545-0477