MEDICARE: INDEPENDENCE CARE OF NEVADA 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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1174367577
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDEPENDENCE CARE OF NEVADA LLC

Provider Business Mailing Address
First Line	:	3301 BONITA BEACH RD STE 208
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-7835
Country	:	US
Telephone Number	:	603-520-1603
Fax Number	:	412-312-3828

Provider Business Practice Location Address
First Line	:	3820 MEADOWS LN STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-3113
Country	:	US
Telephone Number	:	603-520-1603
Fax Number	:	412-312-3828

Authorized Official
Title or Position	:	CEO
Name	:	PHILIP VIAR
Credential	:
Telephone Number	:	603-520-1603

Provider Enumeration Date	:	06/20/2024
Last Update Date	:	05/28/2026

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