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General NPI Number Information
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NPI Number | 1962942201
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Entity Type | Organization
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Legal Business Name | HOMEHEALTH MANAGEMENT AND CONSULTANT AGENCY
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Dates
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Enumeration Date | 03/06/2017
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 4495 W. HACIENDA AVE SUITE 7A
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City | LAS VEGAS
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State | NV
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Zip | 89118-1541
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Country | US
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Telephone | 702-929-3416
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Fax | 702-924-7422
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Provider Business Mailing Address
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Address Line | 4495 W. HACIENDA AVE SUITE 7A
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City | LAS VEGAS
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State | NV
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Zip | 89118-1541
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Country | US
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Telephone | 702-929-3416
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Fax | 702-924-7422
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Authorized Official
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Title or Position | ADMINISTRATOR/DPCS
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Name | MS. JENNIFER JANE VERANO DIAZ
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Credential | RN, MSN, MBA
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Telephone | 702-929-3416
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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 | 8670-HHA-0
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 8933-HHA-0
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License Number State | NV
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