MEDICARE: CANOE HOMES

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

General Provider Information

NPI Number	:	1699522953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANOE HOMES

Provider Business Mailing Address
First Line	:	500 HIDDEN CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-4501
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 HIDDEN CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-4501
Country	:	US
Telephone Number	:	301-254-9554
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	NGOZI UGWU
Credential	:
Telephone Number	:	301-254-9554

Provider Enumeration Date	:	05/03/2024
Last Update Date	:	05/03/2024

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Directions to “CANOE HOMES ” Practice Location

Language	Start Address	Practice Location

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