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General NPI Number Information
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NPI Number | 1538101084
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Entity Type | Organization
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Legal Business Name | HOSPICE OF LAS VEGAS, INC.
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1200 S 4TH ST STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89104-1046
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Country | US
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Telephone | 702-853-9063
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 S 4TH ST STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89104-1046
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Country | US
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Telephone | 702-853-9063
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. HOLLY MONTANO
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Credential | RN
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Telephone | 702-853-9063
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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 | 4540HPC-0
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License Number State | NV
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