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NPI Code Detail

MEDICARE: ACTIVATE HOME HEALTH CARE LLC

MEDICARE: ACTIVATE HOME HEALTH CARE 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1134940489
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACTIVATE HOME HEALTH CARE LLC
Provider Business Mailing Address
First Line : 2626 S RAINBOW BLVD STE 203F
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-4005
Country : US
Telephone Number : 702-845-7292
Fax Number : 702-209-0970
Provider Business Practice Location Address
First Line : 2626 S RAINBOW BLVD STE 203F
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-4005
Country : US
Telephone Number : 702-845-7292
Fax Number : 702-209-0970
Authorized Official
Title or Position : ADMINISTRATOR
Name : MARIA ROWENA MEDINA DE GUZMAN
Credential : BSN, RN, CCDS
Telephone Number : 702-845-7292
Provider Enumeration Date : 10/21/2024
Last Update Date : 10/21/2024

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Directions to “ACTIVATE HOME HEALTH CARE LLC ” Practice Location

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