MEDICARE: RED ROCK HOSPICE

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	251G00000X	Community Based Hospice Care Agency	8861-HPC-0	NV

General Provider Information

NPI Number	:	1922592385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RED ROCK HOSPICE

Provider Business Mailing Address
First Line	:	1811 S RAINBOW BLVD STE 215
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0855
Country	:	US
Telephone Number	:	702-540-7707
Fax Number	:	702-924-5052

Provider Business Practice Location Address
First Line	:	1811 S RAINBOW BLVD STE 215
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0855
Country	:	US
Telephone Number	:	702-540-7707
Fax Number	:	702-924-5052

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. RASTELLI CHARLES REGALADO
Credential	:
Telephone Number	:	702-540-7707

Provider Enumeration Date	:	06/19/2018
Last Update Date	:	09/14/2018

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Directions to “RED ROCK HOSPICE ” Practice Location

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