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General NPI Number Information
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NPI Number | 1841577921
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Entity Type | Organization
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Legal Business Name | ISU INC
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Dates
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Enumeration Date | 11/03/2011
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Last Update Date | 11/08/2011
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Provider Practice Location Address
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Address Line | 1745 N. NELLIS BLVD STE A
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City | LAS VEGAS
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State | NV
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Zip | 89115-3673
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Country | US
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Telephone | 702-459-7500
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Fax | 702-459-1176
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Provider Business Mailing Address
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Address Line | 1745 N. NELLIS BLVD STE A
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City | LAS VEGAS
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State | NV
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Zip | 89115-3673
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Country | US
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Telephone | 702-459-7500
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Fax | 702-459-1176
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHUKA E HUMPHREYS
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Credential | PHD
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Telephone | 702-459-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 6374PCS-0
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 6033HHA-O
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License Number State | NV
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