MEDICARE: CANA HOMEHEALTH AGENCY 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

General Provider Information

NPI Number	:	1184922312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANA HOMEHEALTH AGENCY LLC

Provider Business Mailing Address
First Line	:	4535 W SAHARA AVE
Second Line	:	SUITE 108
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-3625
Country	:	US
Telephone Number	:	702-331-0643
Fax Number	:	702-331-0657

Provider Business Practice Location Address
First Line	:	4535 W SAHARA AVE
Second Line	:	SUITE 108
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-3625
Country	:	US
Telephone Number	:	702-331-0643
Fax Number	:	702-331-0657

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MRS. JOCELYN MOLINA
Credential	:
Telephone Number	:	702-331-0643

Provider Enumeration Date	:	03/11/2011
Last Update Date	:	11/21/2011

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Directions to “CANA HOMEHEALTH AGENCY LLC ” Practice Location

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