MEDICARE: COMPLETE CARE GROUP HOME

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
1	310400000X	Assisted Living Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134580459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE CARE GROUP HOME

Provider Business Mailing Address
First Line	:	1680 SOMBRERO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89169-2564
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2437 HIGH VISTA CIR
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-3707
Country	:	US
Telephone Number	:	702-449-0122
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	DR. STACEY CADAVAL
Credential	:	DNP
Telephone Number	:	702-449-0122

Provider Enumeration Date	:	03/14/2016
Last Update Date	:	03/14/2016

Similar Medicare Providers

1790378867 — NICOLE A SALACUP
Practice Location Address:

2268 SKY ISLAND DR
HENDERSON, NV
89002-3707

Practice Phone: 702-286-5430
Practice Fax:

1104773431 — TANYA VAZQUEZ RN AND SRNA
Practice Location Address:

2030 OLYMPIC AVE APT 2046
HENDERSON, NV
89014-2251

Practice Phone: 915-202-5872
Practice Fax:

1992653042 — EXCELLENT HEALING SOLUTIONS TEXAS LLC
Practice Location Address:

375 N STEPHANIE ST STE 1011
HENDERSON, NV
89014-8901

Practice Phone: 725-724-5817
Practice Fax:

1992653059 — RAFAEL SANCHEZ
Practice Location Address:

2030 OLYMPIC AVE APT 2046
HENDERSON, NV
89014-2251

Practice Phone: 915-309-0025
Practice Fax:

1366390262 — YOUNGMI PARKER AGNP-C
Practice Location Address:

415 INDIGO SPRINGS ST
HENDERSON, NV
89014-3739

Practice Phone: 678-577-9950
Practice Fax:

1295535409 — ANGEL DIVINE HAYNES BA
Practice Location Address:

375 N STEPHANIE ST BLDG 11
HENDERSON, NV
89014-8771

Practice Phone: 702-960-9564
Practice Fax:

Directions to “COMPLETE CARE GROUP HOME ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.