MEDICARE: MILLARD HOLDINGS 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	251E00000X	Home Health Agency	NV20141470833	NV

General Provider Information

NPI Number	:	1194127993
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLARD HOLDINGS NEVADA LLC

Provider Business Mailing Address
First Line	:	3311 S RAINBOW BLVD
Second Line	:	SUITE 106
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6206
Country	:	US
Telephone Number	:	702-722-6060
Fax Number	:	702-722-6061

Provider Business Practice Location Address
First Line	:	3311 S RAINBOW BLVD
Second Line	:	SUITE 106
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6206
Country	:	US
Telephone Number	:	702-722-6060
Fax Number	:	702-722-6061

Authorized Official
Title or Position	:	MANAGER
Name	:	JOHN PARAGAS
Credential	:
Telephone Number	:	702-439-3648

Provider Enumeration Date	:	09/23/2014
Last Update Date	:	03/09/2021

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