Provider Demographics
NPI:1164817342
Name:NEVADA PREFERRED HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:NEVADA PREFERRED HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:BUNA
Authorized Official - Suffix:JR
Authorized Official - Credentials:RN
Authorized Official - Phone:702-896-1117
Mailing Address - Street 1:5600 SPRING MOUNTAIN RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-8823
Mailing Address - Country:US
Mailing Address - Phone:702-896-1117
Mailing Address - Fax:
Practice Address - Street 1:5600 SPRING MOUNTAIN RD STE 203
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146
Practice Address - Country:US
Practice Address - Phone:702-896-1117
Practice Address - Fax:702-988-8792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNV20151025022OtherNSOS