Provider Demographics
NPI:1124577127
Name:MELO HEALTH SYSTEMS LLC
Entity Type:Organization
Organization Name:MELO HEALTH SYSTEMS LLC
Other - Org Name:EXECUTIVE CARE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN PATCHOLO
Authorized Official - Middle Name:MELO
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-217-2676
Mailing Address - Street 1:1771 E FLAMINGO RD
Mailing Address - Street 2:SUITE 119B
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5155
Mailing Address - Country:US
Mailing Address - Phone:702-217-2676
Mailing Address - Fax:
Practice Address - Street 1:1771 E FLAMINGO RD
Practice Address - Street 2:SUITE 119B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5155
Practice Address - Country:US
Practice Address - Phone:702-217-2676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-02
Last Update Date:2016-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8612-HHA-0251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health