Healthcare Provider Details

I. General information

NPI: 1588551956
Provider Name (Legal Business Name): TERICIABEETHEIR MOBILE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 VERBENA ST
PAHRUMP NV
89048-4905
US

IV. Provider business mailing address

2000 VERBENA ST
PAHRUMP NV
89048-4905
US

V. Phone/Fax

Practice location:
  • Phone: 775-537-4703
  • Fax:
Mailing address:
  • Phone: 775-537-4703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: STEPHINE TERICE ROSS
Title or Position: OWNER/ AUTHORIZED AGENT
Credential:
Phone: 775-537-4703