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NPI Code Detail

MEDICARE: DESERT GRACE HEALTH SERVICES, INC.

MEDICARE: DESERT GRACE HEALTH SERVICES, 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
1251E00000XHome Health Agency8057HHA0NV

General Provider Information

NPI Number : 1316343866
Entity Type Code : Organization
Provider Name (Legal Business Name) : DESERT GRACE HEALTH SERVICES, INC.
Provider Business Mailing Address
First Line : 4955 S DURANGO DR STE 117
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-1054
Country : US
Telephone Number : 702-889-9003
Fax Number : 702-889-0644
Provider Business Practice Location Address
First Line : 4955 S DURANGO DR STE 117
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-1054
Country : US
Telephone Number : 702-889-9003
Fax Number : 702-889-0644
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MR. ARTHUR GARIBYAN
Credential :
Telephone Number : 818-731-8551
Provider Enumeration Date : 11/11/2014
Last Update Date : 08/11/2016

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Directions to “DESERT GRACE HEALTH SERVICES, INC. ” Practice Location

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