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NPI Code Detail

MEDICARE: ELDERCARE HEALTHCARE SERVICES LLC

MEDICARE: ELDERCARE HEALTHCARE SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251G00000XCommunity Based Hospice Care Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110118-HPC-0OTHERNVNEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES

General Provider Information

NPI Number : 1073113981
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELDERCARE HEALTHCARE SERVICES LLC
Provider Business Mailing Address
First Line : 5660 W FLAMINGO RD STE C
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-2312
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5660 W FLAMINGO RD STE C
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-2312
Country : US
Telephone Number : 702-744-7420
Fax Number : 702-829-8397
Authorized Official
Title or Position : ADMINISTRATOR
Name : VAUGHN DANAO
Credential :
Telephone Number : 818-299-3110
Provider Enumeration Date : 10/29/2020
Last Update Date : 11/12/2020

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Directions to “ELDERCARE HEALTHCARE SERVICES LLC ” Practice Location

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