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General NPI Number Information
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NPI Number | 1811957830
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Entity Type | Organization
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Legal Business Name | ADDUS HEALTHCARE (NEVADA), INC.
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 05/18/2010
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Provider Practice Location Address
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Address Line | 2140 W CHARLESTON BLVD SUITE B
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City | LAS VEGAS
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State | NV
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Zip | 89102-2253
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Country | US
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Telephone | 702-868-0355
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Fax | 702-868-0307
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Provider Business Mailing Address
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Address Line | 2401 S PLUM GROVE RD
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City | PALATINE
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State | IL
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Zip | 60067-7486
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Country | US
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Telephone | 847-303-5300
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Fax | 847-303-5376
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Authorized Official
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Title or Position | NATIONAL CONTRACTS
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Name | MS. DIANE KUMARICH
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Credential | RN, MS, MBA
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Telephone | 702-868-0355
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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 |
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License Number State | NV
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