MEDICARE: BE WELL 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
1	251E00000X	Home Health Agency	H1400231A139351	NV

General Provider Information

NPI Number	:	1184892036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BE WELL HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	3110 S VALLEY VIEW BOULEVARD
Second Line	:	SUITE 201
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8389
Country	:	US
Telephone Number	:	702-644-9208
Fax Number	:	702-644-9209

Provider Business Practice Location Address
First Line	:	3110 S VALLEY VIEW BOULEVARD
Second Line	:	SUITE 201
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8389
Country	:	US
Telephone Number	:	702-644-9208
Fax Number	:	702-644-9209

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. RAFAEL ARSHAKUNI
Credential	:
Telephone Number	:	702-994-8940

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	05/02/2008

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