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General NPI Number Information
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NPI Number | 1568691855
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Entity Type | Organization
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Legal Business Name | MAXICARE HOMEHEALTH INC.
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 2801 S VALLEY VIEW BLVD STE 5-C
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City | LAS VEGAS
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State | NV
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Zip | 89102-0116
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Country | US
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Telephone | 702-369-1006
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Fax | 702-369-6007
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Provider Business Mailing Address
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Address Line | 2801 S VALLEY VIEW BLVD STE 5-C
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City | LAS VEGAS
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State | NV
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Zip | 89102-0116
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Country | US
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Telephone | 702-369-1006
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Fax | 702-369-6007
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Authorized Official
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Title or Position | PRESIDENT/ ADMINISTRATOR
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Name | MICHELLE GAY LIM
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Credential |
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Telephone | 702-354-5478
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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 | 2000164-319
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License Number State | NV
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