Healthcare Provider Details

I. General information

NPI: 1801454236
Provider Name (Legal Business Name): ELSA HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2019
Last Update Date: 05/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 S MARYLAND PKWY STE 512A
LAS VEGAS NV
89109-1568
US

IV. Provider business mailing address

2770 S MARYLAND PKWY STE 512A
LAS VEGAS NV
89109-1568
US

V. Phone/Fax

Practice location:
  • Phone: 702-331-0100
  • Fax:
Mailing address:
  • Phone: 702-331-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: VILMA AFANTE
Title or Position: ADMINISTRATOR
Credential:
Phone: 818-879-3082