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General NPI Number Information
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NPI Number | 1619355047
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Entity Type | Organization
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Legal Business Name | EAGLE HOME HEALTH AGENCY INC
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Dates
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Enumeration Date | 05/18/2015
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Last Update Date | 05/18/2015
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Provider Practice Location Address
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Address Line | 222 S RAINBOW BLVD SUITE 202
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City | LAS VEGAS
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State | NV
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Zip | 89145-5340
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Country | US
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Telephone | 702-242-4242
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Fax | 702-242-4243
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Provider Business Mailing Address
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Address Line | 222 S RAINBOW BLVD SUITE 202
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City | LAS VEGAS
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State | NV
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Zip | 89145-5340
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Country | US
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Telephone | 702-242-4242
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Fax | 702-242-4243
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | HELEN AUSTIN
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Credential | RN
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Telephone | 702-242-4242
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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 | H14-00396
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License Number State | NV
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