Healthcare Provider Details

I. General information

NPI: 1902542327
Provider Name (Legal Business Name): PRODUCTIVE HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 05/09/2022
Certification Date: 05/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 W CRAIG RD STE A
N LAS VEGAS NV
89032-5116
US

IV. Provider business mailing address

3435 W CRAIG RD STE C
N LAS VEGAS NV
89032-5116
US

V. Phone/Fax

Practice location:
  • Phone: 702-929-3297
  • Fax: 702-750-9927
Mailing address:
  • Phone: 702-929-3297
  • Fax: 702-750-9927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NICHOLE NELSON-PHILLIPS
Title or Position: PRESIDENT
Credential:
Phone: 702-929-3297