MEDICARE: INTRA CARE HOME HEALTH LV, 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1285439315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTRA CARE HOME HEALTH LV, INC

Provider Business Mailing Address
First Line	:	6655 W SAHARA AVE STE B109
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0850
Country	:	US
Telephone Number	:	702-329-1901
Fax Number	:	702-329-1913

Provider Business Practice Location Address
First Line	:	6655 W SAHARA AVE STE B109
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0850
Country	:	US
Telephone Number	:	702-329-1901
Fax Number	:	702-329-1913

Authorized Official
Title or Position	:	CEO
Name	:	DIONALYN UGBEBOR
Credential	:	RN
Telephone Number	:	702-329-1901

Provider Enumeration Date	:	02/13/2025
Last Update Date	:	02/13/2025

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