Provider Demographics
NPI:1073111571
Name:CHS HOSPICE LLC
Entity Type:Organization
Organization Name:CHS HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEMETRIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ENCABO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-489-9355
Mailing Address - Street 1:2330 PASEO DEL PRADO STE C201
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-4376
Mailing Address - Country:US
Mailing Address - Phone:702-489-9355
Mailing Address - Fax:702-413-6333
Practice Address - Street 1:2330 PASEO DEL PRADO STE C201
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4376
Practice Address - Country:US
Practice Address - Phone:702-489-9355
Practice Address - Fax:702-413-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Single Specialty