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General NPI Number Information
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NPI Number | 1922440924
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Entity Type | Organization
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Legal Business Name | HOMETRUST HEALTHCARE, LLC
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Dates
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Enumeration Date | 07/19/2013
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Last Update Date | 07/19/2013
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Provider Practice Location Address
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Address Line | 4535 W SAHARA AVE
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City | LAS VEGAS
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State | NV
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Zip | 89102-3625
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Country | US
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Telephone | 702-948-8919
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Fax | 702-413-7701
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Provider Business Mailing Address
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Address Line | 4535 W SAHARA AVE
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City | LAS VEGAS
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State | NV
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Zip | 89102-3625
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Country | US
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Telephone | 702-948-8919
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Fax | 702-413-7701
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. CECILIA CALLAO LABINPUNO
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Credential | LPN
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Telephone | 702-948-8919
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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 | 7627PCS-0
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License Number State | NV
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