MEDICARE: ADDUS HEALTHCARE (NEVADA), 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		NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811957830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADDUS HEALTHCARE (NEVADA), INC.

Provider Business Mailing Address
First Line	:	2401 S PLUM GROVE RD
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-7486
Country	:	US
Telephone Number	:	847-303-5300
Fax Number	:	847-303-5376

Provider Business Practice Location Address
First Line	:	2140 W CHARLESTON BLVD
Second Line	:	SUITE B
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2253
Country	:	US
Telephone Number	:	702-868-0355
Fax Number	:	702-868-0307

Authorized Official
Title or Position	:	NATIONAL CONTRACTS
Name	:	MS. DIANE KUMARICH
Credential	:	RN, MS, MBA
Telephone Number	:	702-868-0355

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	05/18/2010

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