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General NPI Number Information
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NPI Number | 1861621013
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Entity Type | Organization
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Legal Business Name | LAS VEGAS HEALTH SYSTEM LLC
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 07/09/2009
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Provider Practice Location Address
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Address Line | 3111 S VALLEY VIEW BLVD SUITE A216
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City | LAS VEGAS
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State | NV
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Zip | 89102-8317
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Country | US
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Telephone | 702-259-0036
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Fax | 702-259-0069
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Provider Business Mailing Address
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Address Line | 3111 S VALLEY VIEW BLVD SUITE A-216
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City | LAS VEGAS
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State | NV
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Zip | 89102-8317
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Country | US
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Telephone | 702-259-0036
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Fax | 702-259-0069
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Authorized Official
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Title or Position | CEO
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Name | MRS. MARIA GRACIA V RETRATO
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Credential |
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Telephone | 702-259-0036
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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 | 5512HHA-0
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License Number State | NV
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