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General NPI Number Information
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NPI Number | 1942954896
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Entity Type | Organization
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Legal Business Name | PROCARE HOME HEALTH LLC
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Dates
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Enumeration Date | 02/09/2022
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Last Update Date | 02/09/2022
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Provider Practice Location Address
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Address Line | 6655 W SAHARA AVE STE D110
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City | LAS VEGAS
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State | NV
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Zip | 89146-0846
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Country | US
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Telephone | 702-372-8140
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Fax |
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Provider Business Mailing Address
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Address Line | 6655 W SAHARA AVE STE D110
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City | LAS VEGAS
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State | NV
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Zip | 89146-0846
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Country | US
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Telephone | 702-372-8140
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | TADESSE KEBEDE
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Credential |
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Telephone | 702-372-8140
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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 |
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