Provider Demographics
NPI:1124568464
Name:ALPINE HOME HEALTH, INC
Entity Type:Organization
Organization Name:ALPINE HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:I
Authorized Official - Last Name:KAMATOY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:702-586-0785
Mailing Address - Street 1:3017 W. CHARLESTON BLVD.
Mailing Address - Street 2:SUITE 51 A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102
Mailing Address - Country:US
Mailing Address - Phone:702-586-0785
Mailing Address - Fax:702-586-0190
Practice Address - Street 1:3017 W. CHARLESTON BLVD.
Practice Address - Street 2:SUITE 51 A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102
Practice Address - Country:US
Practice Address - Phone:702-586-0785
Practice Address - Fax:702-586-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-06
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8558-HHA-0251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health