Provider Demographics
NPI:1164086583
Name:VALLEY HOSPICE OF NEVADA LLC
Entity Type:Organization
Organization Name:VALLEY HOSPICE OF NEVADA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VEACESLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:BALAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-715-0835
Mailing Address - Street 1:5918 TYBALT CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-0251
Mailing Address - Country:US
Mailing Address - Phone:917-797-3265
Mailing Address - Fax:
Practice Address - Street 1:187 N GIBSON RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-6713
Practice Address - Country:US
Practice Address - Phone:702-932-8600
Practice Address - Fax:702-448-8555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-01
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based