MEDICARE: HONESTY HOME HEALTH 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1659996676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HONESTY HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	5024 ALTA DR STE B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-3927
Country	:	US
Telephone Number	:	702-984-7988
Fax Number	:	702-727-4358

Provider Business Practice Location Address
First Line	:	5024 ALTA DR STE B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-3927
Country	:	US
Telephone Number	:	702-984-7988
Fax Number	:	702-727-4358

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	PAUL JAMES DE CHAVEZ OBUNGEN
Credential	:	RN
Telephone Number	:	908-265-3303

Provider Enumeration Date	:	06/16/2020
Last Update Date	:	06/21/2020

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Directions to “HONESTY HOME HEALTH CARE LLC ” Practice Location

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