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NPI Code Detail

MEDICARE: CHS CARING PROVIDERS LLC

MEDICARE: CHS CARING PROVIDERS 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
1363L00000XNurse Practitioner
2261QC1500XCommunity Health Clinic/Center

General Provider Information

NPI Number : 1881292381
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHS CARING PROVIDERS LLC
Provider Business Mailing Address
First Line : 2330 PASEO DEL PRADO STE C201
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-4376
Country : US
Telephone Number : 702-489-9355
Fax Number : 702-413-6333
Provider Business Practice Location Address
First Line : 2330 PASEO DEL PRADO STE C201
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-4376
Country : US
Telephone Number : 702-489-9355
Fax Number : 702-413-6333
Authorized Official
Title or Position : MANAGER
Name : DEMETRIO ENCABO
Credential :
Telephone Number : 702-489-9355
Provider Enumeration Date : 10/15/2020
Last Update Date : 07/13/2021

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Directions to “CHS CARING PROVIDERS LLC ” Practice Location

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