MEDICARE: ACCLAIMED 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	5341PCS2	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588932479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCLAIMED IN HOME CARE, LLC

Provider Business Mailing Address
First Line	:	1500 E TROPICANA AVE
Second Line	:	#221
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6514
Country	:	US
Telephone Number	:	702-255-1239
Fax Number	:	702-256-1238

Provider Business Practice Location Address
First Line	:	1500 E TROPICANA AVE
Second Line	:	#221
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6514
Country	:	US
Telephone Number	:	702-255-1239
Fax Number	:	702-256-1238

Authorized Official
Title or Position	:	ADMINISTRATOR/OWNER
Name	:	MS. SYDNEY LOUISE GENOVA
Credential	:
Telephone Number	:	702-255-1239

Provider Enumeration Date	:	12/06/2011
Last Update Date	:	12/06/2011

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Directions to “ACCLAIMED IN HOME CARE, LLC ” Practice Location

Language	Start Address	Practice Location

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