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General NPI Number Information
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NPI Number | 1578617387
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Entity Type | Organization
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Legal Business Name | NEVADA DESERT HOME HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 09/01/2010
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Provider Practice Location Address
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Address Line | 4170 S DECATUR BLVD STE D6
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City | LAS VEGAS
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State | NV
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Zip | 89103-6815
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Country | US
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Telephone | 702-222-3911
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Fax | 702-220-3911
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Provider Business Mailing Address
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Address Line | 4170 S DECATUR BLVD STE D6
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City | LAS VEGAS
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State | NV
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Zip | 89103-6815
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Country | US
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Telephone | 702-222-3911
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Fax | 702-220-3911
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. SHARON ANN KEAN
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Credential | RN
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Telephone | 818-974-2676
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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 | 4593HHA-1
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License Number State | NV
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