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NPI Code Detail

MEDICARE: GRACE HOSPICE OF NEVADA LLC

MEDICARE: GRACE HOSPICE OF NEVADA 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
1251G00000XCommunity Based Hospice Care AgencyNV20181348397NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NV20181348397OTHERNVNEVADA STATE BUSINESS LICENSE

General Provider Information

NPI Number : 1962996793
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRACE HOSPICE OF NEVADA 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 : 702-201-1807
Fax Number : 725-307-8717
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 : 702-201-1807
Fax Number : 725-307-8717
Authorized Official
Title or Position : OTHER
Name : MR. DEMETRIO ENCABO
Credential : RN
Telephone Number : 702-201-1807
Provider Enumeration Date : 06/15/2018
Last Update Date : 01/16/2025

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Directions to “GRACE HOSPICE OF NEVADA LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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