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NPI Code Detail

MEDICARE: INDAHOUSE HOMEHEALTH CARE, LLC.

MEDICARE: INDAHOUSE HOMEHEALTH CARE, 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1477228104
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDAHOUSE HOMEHEALTH CARE, LLC.
Provider Business Mailing Address
First Line : 3305 SPRING MOUNTAIN RD STE 53
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-8620
Country : US
Telephone Number : 725-204-8351
Fax Number : 725-214-5555
Provider Business Practice Location Address
First Line : 3305 SPRING MOUNTAIN RD STE 53
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-8620
Country : US
Telephone Number : 725-204-8351
Fax Number : 725-214-5555
Authorized Official
Title or Position : OWNER
Name : MR. RIZALDY BORJA VILLASFER
Credential :
Telephone Number : 702-606-3989
Provider Enumeration Date : 08/13/2021
Last Update Date : 03/31/2025

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Directions to “INDAHOUSE HOMEHEALTH CARE, LLC. ” Practice Location

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