MEDICARE: PROMISE HOME 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1720235575
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROMISE HOME HEALTH INC

Provider Business Mailing Address
First Line	:	2801 S VALLEY VIEW BLVD
Second Line	:	STE # 3
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-0116
Country	:	US
Telephone Number	:	562-980-6036
Fax Number	:

Provider Business Practice Location Address
First Line	:	2801 S VALLEY VIEW BLVD
Second Line	:	STE # 3
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-0116
Country	:	US
Telephone Number	:	562-980-6036
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	EMMALYN V ALCANTARA
Credential	:
Telephone Number	:	562-980-6036

Provider Enumeration Date	:	08/23/2008
Last Update Date	:	08/23/2008

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Directions to “PROMISE HOME HEALTH INC ” Practice Location

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