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General NPI Number Information
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NPI Number | 1073662185
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Entity Type | Organization
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Legal Business Name | CHISAL ENTERPRISES, INC.
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6230 MCLEOD DR SUITE #100
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City | LAS VEGAS
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State | NV
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Zip | 89120-4442
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Country | US
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Telephone | 702-898-2212
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Fax | 702-898-2201
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Provider Business Mailing Address
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Address Line | 6230 MCLEOD DR SUITE #100
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City | LAS VEGAS
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State | NV
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Zip | 89120-4442
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Country | US
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Telephone | 702-898-2212
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JENNIFER A BASILIO
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Credential | RN
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Telephone | 702-898-2212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 4584HHA-1
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License Number State | NV
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