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General NPI Number Information
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NPI Number | 1124360052
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Entity Type | Organization
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Legal Business Name | 247 HOSPICE LAS VEGAS INC
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Dates
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Enumeration Date | 03/18/2013
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Last Update Date | 04/22/2013
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Provider Practice Location Address
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Address Line | 3651 LINDELL RD STE K
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City | LAS VEGAS
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State | NV
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Zip | 89103-1254
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Country | US
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Telephone | 702-297-8888
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Fax | 702-988-8813
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Provider Business Mailing Address
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Address Line | 16027 BROOKHURST ST I-341
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-1551
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/DPCS
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Name | GINA CASTROMAYOR
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Credential | RN
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Telephone | 702-297-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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