MEDICARE: 4 HEALTH NUTS NV 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	:	1528907763
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	4 HEALTH NUTS NV LLC

Provider Business Mailing Address
First Line	:	3838 RAYMERT DR STE 12
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-3247
Country	:	US
Telephone Number	:	917-579-5441
Fax Number	:

Provider Business Practice Location Address
First Line	:	3838 RAYMERT DR STE 12
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-3247
Country	:	US
Telephone Number	:	917-579-5441
Fax Number	:

Authorized Official
Title or Position	:	MEMBER MANAGER
Name	:	LANCE DIAMOND
Credential	:
Telephone Number	:	917-579-5441

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	03/25/2026

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Directions to “4 HEALTH NUTS NV LLC ” Practice Location

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