MEDICARE: INNOVATIONS IN HOME 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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1518241256
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOVATIONS IN HOME CARE, LLC

Provider Business Mailing Address
First Line	:	774 MARANELLO ST
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-5776
Country	:	US
Telephone Number	:	702-686-4551
Fax Number	:	702-823-1494

Provider Business Practice Location Address
First Line	:	340 E WARM SPRINGS RD
Second Line	:	SUITE 1B
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4257
Country	:	US
Telephone Number	:	702-606-9356
Fax Number	:	702-823-1494

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MS. LAURIE SLINGERLAND
Credential	:
Telephone Number	:	702-686-4551

Provider Enumeration Date	:	09/29/2011
Last Update Date	:	10/11/2011

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