MEDICARE: VIP 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	3872HHA-10	NV

General Provider Information

NPI Number	:	1770529984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIP HOME HEALTH, INC

Provider Business Mailing Address
First Line	:	3100 W CHARLESTON BLVD
Second Line	:	STE 208
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1900
Country	:	US
Telephone Number	:	702-880-3847
Fax Number	:	702-880-3848

Provider Business Practice Location Address
First Line	:	3100 W CHARLESTON BLVD
Second Line	:	STE 208
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1900
Country	:	US
Telephone Number	:	702-880-3847
Fax Number	:	702-880-3848

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ADRIAN SABALONES
Credential	:
Telephone Number	:	702-880-3847

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	12/20/2007

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Directions to “VIP HOME HEALTH, INC ” Practice Location

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