Healthcare Provider Details

I. General information

NPI: 1255641460
Provider Name (Legal Business Name): OCEAN HOME HEALTH CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2010
Last Update Date: 10/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8871 W FLAMINGO RD STE 202
LAS VEGAS NV
89147-8729
US

IV. Provider business mailing address

8871 W FLAMINGO RD STE 202
LAS VEGAS NV
89147-8729
US

V. Phone/Fax

Practice location:
  • Phone: 702-522-6822
  • Fax: 702-868-6205
Mailing address:
  • Phone: 702-522-6822
  • Fax: 702-868-6205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH DEVON LEWELLYN
Title or Position: CEO
Credential:
Phone: 702-807-9392