MEDICARE: SOUTHERN NEVADA HOME HEALTH CARE, INC.

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	251G00000X	Community Based Hospice Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	6228HPC-6	OTHER	NV	STATE LICENSE

General Provider Information

NPI Number	:	1194828350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN NEVADA HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	12900 FOSTER ST
Second Line	:	STE. 400
City	:	OVERLAND PARK
State	:	KS
Zip	:	66213-2704
Country	:	US
Telephone Number	:	913-814-2674
Fax Number	:

Provider Business Practice Location Address
First Line	:	9121 W RUSSELL RD
Second Line	:	STE. 118
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1236
Country	:	US
Telephone Number	:	702-228-0282
Fax Number	:

Authorized Official
Title or Position	:	ASSISTANT SECRETARY
Name	:	RUTH SCHWARTZ
Credential	:
Telephone Number	:	913-814-2288

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	09/12/2016

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