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NPI Code Detail

MEDICARE: CREST VALLEY HOME HEALTH LLC

MEDICARE: CREST VALLEY HOME HEALTH 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1770392995
Entity Type Code : Organization
Provider Name (Legal Business Name) : CREST VALLEY HOME HEALTH LLC
Provider Business Mailing Address
First Line : 2626 S RAINBOW BLVD STE 203E
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-4005
Country : US
Telephone Number : 702-377-5810
Fax Number :
Provider Business Practice Location Address
First Line : 2626 S RAINBOW BLVD STE 203E
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-4005
Country : US
Telephone Number : 702-377-5810
Fax Number :
Authorized Official
Title or Position : MANAGING MEMBER
Name : DEMETRIO FLORES
Credential :
Telephone Number : 702-377-5810
Provider Enumeration Date : 01/02/2025
Last Update Date : 01/02/2025

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Directions to “CREST VALLEY HOME HEALTH LLC ” Practice Location

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