MEDICARE: IMAGINE COMPANIONS

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	133N00000X	Nutritionist
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1386573830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMAGINE COMPANIONS

Provider Business Mailing Address
First Line	:	8212 CALICO WIND ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-5508
Country	:	US
Telephone Number	:	702-682-1383
Fax Number	:	702-682-1383

Provider Business Practice Location Address
First Line	:	8212 CALICO WIND ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-5508
Country	:	US
Telephone Number	:	702-682-1383
Fax Number	:	702-682-1383

Authorized Official
Title or Position	:	MANAGER
Name	:	GIA GUGLIELMO
Credential	:
Telephone Number	:	702-682-1383

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/22/2026

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Directions to “IMAGINE COMPANIONS ” Practice Location

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