MEDICARE: ATLAS HOME HEALTH CARE OF NEVADA, 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	251E00000X	Home Health Agency	4362HHA2	NV

General Provider Information

NPI Number	:	1548459522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLAS HOME HEALTH CARE OF NEVADA, LLC

Provider Business Mailing Address
First Line	:	8940 S MARYLAND PKWY
Second Line	:	SUITE 400
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-5362
Country	:	US
Telephone Number	:	702-614-1925
Fax Number	:	702-614-0733

Provider Business Practice Location Address
First Line	:	8940 S MARYLAND PKWY
Second Line	:	SUITE 400
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-5362
Country	:	US
Telephone Number	:	702-614-1925
Fax Number	:	702-614-0733

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. DELAILA LAPID
Credential	:
Telephone Number	:	702-614-1925

Provider Enumeration Date	:	10/16/2007
Last Update Date	:	10/16/2007

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