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General NPI Number Information
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NPI Number | 1528173135
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Entity Type | Organization
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Legal Business Name | EDICO HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3365 W CRAIG RD SUITE 19
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032-5112
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Country | US
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Telephone | 702-645-0745
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Fax | 702-697-2006
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Provider Business Mailing Address
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Address Line | 3365 W CRAIG RD SUITE 19
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032-5112
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Country | US
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Telephone | 702-645-0745
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Fax | 702-697-2006
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. EDITH P. AVANZADO
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Credential |
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Telephone | 626-893-0394
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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 |
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License Number State |
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