MEDICARE: PUNSI HOME CARE AGENCY

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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1588482301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUNSI HOME CARE AGENCY

Provider Business Mailing Address
First Line	:	3202 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1932
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3202 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1932
Country	:	US
Telephone Number	:	702-640-0147
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LAURE YIMGA JAEGER
Credential	:
Telephone Number	:	702-640-0147

Provider Enumeration Date	:	10/01/2024
Last Update Date	:	10/01/2024

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Directions to “PUNSI HOME CARE AGENCY ” Practice Location

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