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NPI Code Detail

MEDICARE: HAYDEELYN AGOJO

MEDICARE:   HAYDEELYN  AGOJO
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
1376J00000XHomemakerG63-02022NV
2372500000XChore ProviderG63-02022NV
3372600000XAdult CompanionG63-02022NV
4374U00000XHome Health AideG63-02022NV

General Provider Information

NPI Number : 1689028342
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAYDEELYN AGOJO
Provider Business Mailing Address
First Line : 6855 W CHARLESTON BLVD STE B
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-1675
Country : US
Telephone Number : 702-241-2050
Fax Number : 702-241-2051
Provider Business Practice Location Address
First Line : 6855 W CHARLESTON BLVD STE B
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-1675
Country : US
Telephone Number : 702-241-2050
Fax Number : 702-241-2051
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2016
Last Update Date : 04/19/2016

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Directions to “ HAYDEELYN AGOJO ” Practice Location

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