Provider Demographics
NPI:1114540424
Name:PELACHO HOME HEALTH INC
Entity Type:Organization
Organization Name:PELACHO HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:ONAIRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDIVIESO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-241-4761
Mailing Address - Street 1:1325 S EASTERN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3901
Mailing Address - Country:US
Mailing Address - Phone:702-241-4761
Mailing Address - Fax:702-227-7209
Practice Address - Street 1:1325 S EASTERN AVE STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3901
Practice Address - Country:US
Practice Address - Phone:702-241-4761
Practice Address - Fax:702-227-7209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health