MEDICARE: EZER PERSONAL CARE SERVICES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	372500000X	Chore Provider
2	3747P1801X	Personal Care Attendant
3	385H00000X	Respite Care
4	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1154192581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EZER PERSONAL CARE SERVICES

Provider Business Mailing Address
First Line	:	720 E CHARLESTON BLVD STE 160
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-1542
Country	:	US
Telephone Number	:	702-695-0117
Fax Number	:

Provider Business Practice Location Address
First Line	:	720 E CHARLESTON BLVD STE 160
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-1542
Country	:	US
Telephone Number	:	702-695-0117
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	NICOLAS LEE
Credential	:
Telephone Number	:	702-695-0117

Provider Enumeration Date	:	01/15/2024
Last Update Date	:	01/15/2024

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