MEDICARE: NEW LIFE PERSONAL CARE 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
1	251E00000X	Home Health Agency	H14-00132-L-119922	NV

General Provider Information

NPI Number	:	1881776474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW LIFE PERSONAL CARE LLC.,

Provider Business Mailing Address
First Line	:	1101 N DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-1220
Country	:	US
Telephone Number	:	702-258-9617
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 N DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-1220
Country	:	US
Telephone Number	:	702-258-9617
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. FLOR GOMEZ-CRUZ
Credential	:
Telephone Number	:	702-258-9617

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	08/22/2020

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