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General NPI Number Information
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NPI Number | 1366951204
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Entity Type | Organization
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Legal Business Name | COMPASSIONATE HEARTS PERSONAL CARE LLC
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Dates
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Enumeration Date | 09/22/2017
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Last Update Date | 09/22/2017
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Provider Practice Location Address
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Address Line | 1104 ALLURE DR
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City | LAS VEGAS
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State | NV
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Zip | 89128-2095
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Country | US
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Telephone | 702-702-7020
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 753394
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City | LAS VEGAS
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State | NV
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Zip | 89136-3394
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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 | OWNER
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Name | TERRI JACKSON
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Credential |
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Telephone | 702-702-7020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | NV
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