=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770306532
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MILES OF SMILES HOME CARE SERVICES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/31/2024
-----------------------------------------------------
Last Update Date | 09/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1180 N TOWN CENTER DR STE 100
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89144-6308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 725-308-2788
-----------------------------------------------------
Fax | 725-316-5247
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1180 N TOWN CENTER DR STE 100
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89144-6308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 725-308-2788
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | WADAH SALIM
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 207-544-6999
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------