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General NPI Number Information
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NPI Number | 1922592385
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Entity Type | Organization
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Legal Business Name | RED ROCK HOSPICE
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 1811 S RAINBOW BLVD STE 215
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City | LAS VEGAS
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State | NV
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Zip | 89146-0855
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Country | US
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Telephone | 702-540-7707
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Fax | 702-924-5052
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Provider Business Mailing Address
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Address Line | 1811 S RAINBOW BLVD STE 215
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City | LAS VEGAS
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State | NV
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Zip | 89146-0855
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Country | US
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Telephone | 702-540-7707
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Fax | 702-924-5052
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. RASTELLI CHARLES REGALADO
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Credential |
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Telephone | 702-540-7707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 8861-HPC-0
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License Number State | NV
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