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General NPI Number Information
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NPI Number | 1467257519
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Entity Type | Organization
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Legal Business Name | GARDEN HOME HEALTH SERVICES LLC
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 5000 W OAKEY BLVD STE A10
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City | LAS VEGAS
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State | NV
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Zip | 89146-3394
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Country | US
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Telephone | 725-203-3477
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Fax | 702-446-0093
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Provider Business Mailing Address
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Address Line | 5000 W OAKEY BLVD STE A10
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City | LAS VEGAS
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State | NV
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Zip | 89146-3394
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Country | US
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Telephone | 725-203-3477
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Fax | 702-446-0093
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Authorized Official
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Title or Position | OWNER
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Name | MR. ILDEFONSO TRINIDAD MANUEL JR.
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Credential |
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Telephone | 725-203-3477
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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 |
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License Number State |
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