=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275147860
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AT-HOME CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2020
-----------------------------------------------------
Last Update Date | 03/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2310 PASEO DEL PRADO STE A206
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89102-4330
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-463-9570
-----------------------------------------------------
Fax | 702-714-1864
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4955 S DURANGO DR STE 153
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89113-0154
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-463-9585
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/ADMINISTRATOR/BOARD MEMBER
-----------------------------------------------------
Name | NYMPHA C GARCIA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 702-463-9570
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------