Provider Demographics
NPI:1003566027
Name:AMITY HOSPICE CARE LLC
Entity Type:Organization
Organization Name:AMITY HOSPICE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DEVELOPMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VYJAY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BALANGUE
Authorized Official - Suffix:
Authorized Official - Credentials:BUSINESS DEVELOPMENT
Authorized Official - Phone:702-954-9798
Mailing Address - Street 1:1515 E TROPICANA AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6519
Mailing Address - Country:US
Mailing Address - Phone:702-777-1285
Mailing Address - Fax:
Practice Address - Street 1:1515 E TROPICANA AVE STE 300
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6519
Practice Address - Country:US
Practice Address - Phone:702-777-1285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based