MEDICARE: RED ROCK HOME HEALTH CARE CORPORATION

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	:	1588321251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RED ROCK HOME HEALTH CARE CORPORATION

Provider Business Mailing Address
First Line	:	3037 E WARM SPRINGS RD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3759
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3037 E WARM SPRINGS RD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3759
Country	:	US
Telephone Number	:	702-488-4197
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KAITLYN CAUDILLO
Credential	:
Telephone Number	:	702-488-4197

Provider Enumeration Date	:	11/17/2021
Last Update Date	:	11/17/2021

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