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General NPI Number Information
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NPI Number | 1225415185
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Entity Type | Organization
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Legal Business Name | FIDELITY HOME HEALTH SERVICES LLC
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 04/29/2015
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Provider Practice Location Address
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Address Line | 5250 S PECOS RD SUITE 100B
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City | LAS VEGAS
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State | NV
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Zip | 89120-1289
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Country | US
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Telephone | 702-912-4442
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Fax | 702-912-4443
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Provider Business Mailing Address
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Address Line | 5250 S PECOS RD SUITE 100B
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City | LAS VEGAS
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State | NV
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Zip | 89120-1289
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Country | US
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Telephone | 702-912-4442
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Fax | 702-912-4443
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Authorized Official
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Title or Position | MEMBER
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Name | MARIA JUDITA G QUANO
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Credential |
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Telephone | 702-912-4442
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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 | NVS8121HHA
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License Number State | NV
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