MEDICARE: CELESTINE HEALTH INC.

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	251G00000X	Community Based Hospice Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0	OTHER		INDIVIDUALS PAY DIRECTLY

General Provider Information

NPI Number	:	1699333708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CELESTINE HEALTH INC.

Provider Business Mailing Address
First Line	:	4525 DEAN MARTIN DR UNIT 307
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-8103
Country	:	US
Telephone Number	:	856-448-5794
Fax Number	:

Provider Business Practice Location Address
First Line	:	4525 DEAN MARTIN DR UNIT 307
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-8103
Country	:	US
Telephone Number	:	856-448-5794
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	THASIN JAIGIRDAR
Credential	:
Telephone Number	:	856-448-5794

Provider Enumeration Date	:	06/04/2019
Last Update Date	:	11/27/2023

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Directions to “CELESTINE HEALTH INC. ” Practice Location

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