Provider Demographics
NPI:1083855662
Name:GREAT CARE HOME HEALTH, LLC
Entity Type:Organization
Organization Name:GREAT CARE HOME HEALTH, LLC
Other - Org Name:GREAT CARE HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BICIERRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-876-7612
Mailing Address - Street 1:953 E SAHARA AVE
Mailing Address - Street 2:F-23
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3005
Mailing Address - Country:US
Mailing Address - Phone:702-697-2184
Mailing Address - Fax:702-697-2185
Practice Address - Street 1:953 E SAHARA AVE
Practice Address - Street 2:F-23
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3005
Practice Address - Country:US
Practice Address - Phone:702-697-2184
Practice Address - Fax:702-697-2185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5042HHA1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health