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General NPI Number Information
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NPI Number | 1477228104
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Entity Type | Organization
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Legal Business Name | INDAHOUSE HOMEHEALTH CARE, LLC.
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Dates
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Enumeration Date | 08/13/2021
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 3305 SPRING MOUNTAIN RD STE 53
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City | LAS VEGAS
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State | NV
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Zip | 89102-8620
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Country | US
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Telephone | 725-204-8351
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Fax | 725-214-5555
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Provider Business Mailing Address
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Address Line | 3305 SPRING MOUNTAIN RD STE 53
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City | LAS VEGAS
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State | NV
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Zip | 89102-8620
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Country | US
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Telephone | 725-204-8351
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Fax | 725-214-5555
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Authorized Official
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Title or Position | OWNER
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Name | MR. RIZALDY BORJA VILLASFER
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Credential |
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Telephone | 702-606-3989
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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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