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General NPI Number Information
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NPI Number | 1427366699
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Entity Type | Organization
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Legal Business Name | JIREH HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 09/21/2010
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Last Update Date | 10/19/2016
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Provider Practice Location Address
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Address Line | 2320 PASEO DEL PRADO SUITE B101
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City | LAS VEGAS
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State | NV
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Zip | 89102-0048
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Country | US
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Telephone | 702-359-1388
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Fax | 702-359-2388
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Provider Business Mailing Address
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Address Line | 2320 PASEO DEL PRADO SUITE B101
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City | LAS VEGAS
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State | NV
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Zip | 89102-0048
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Country | US
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Telephone | 702-359-1388
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Fax | 702-359-2388
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Authorized Official
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Title or Position | CEO
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Name | MR. ROMEO A SEDANO JR.
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Credential |
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Telephone | 702-359-1388
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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 | H14-00300-H-151012
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License Number State | NV
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