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General NPI Number Information
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NPI Number | 1558871822
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Entity Type | Organization
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Legal Business Name | ADVISACARE SOLUTIONS OF NEVADA, INC.
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Dates
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Enumeration Date | 10/02/2017
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Last Update Date | 10/02/2017
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Provider Practice Location Address
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Address Line | 1840 E WARM SPRINGS RD STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89119-4585
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Country | US
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Telephone | 702-837-0699
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Fax | 702-896-6401
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Provider Business Mailing Address
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Address Line | 4234 CASCADE RD SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-8384
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Country | US
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Telephone | 616-464-1117
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Fax | 616-464-1044
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Authorized Official
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Title or Position | PRESIDENT
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Name | KRISTIAN E SKOGEN
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Credential |
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Telephone | 702-837-0699
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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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