Healthcare Provider Details

I. General information

NPI: 1366066953
Provider Name (Legal Business Name): DELIGHTFUL HEARTS HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2020
Last Update Date: 01/25/2021
Certification Date: 01/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7251 W LAKE MEAD BLVD STE 300
LAS VEGAS NV
89128-8380
US

IV. Provider business mailing address

7251 W LAKE MEAD BLVD STE 300
LAS VEGAS NV
89128-8380
US

V. Phone/Fax

Practice location:
  • Phone: 702-562-4000
  • Fax:
Mailing address:
  • Phone: 702-562-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: GWENDOLYN JOHNSON-HALL
Title or Position: CO-OWNER
Credential:
Phone: 702-562-4000