Provider Demographics
NPI:1275147860
Name:AT-HOME CARE LLC
Entity Type:Organization
Organization Name:AT-HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:AGANON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-806-6468
Mailing Address - Street 1:4955 S DURANGO DR STE 153
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-0154
Mailing Address - Country:US
Mailing Address - Phone:702-463-9585
Mailing Address - Fax:
Practice Address - Street 1:4955 S DURANGO DR STE 153
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-0154
Practice Address - Country:US
Practice Address - Phone:702-463-9585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based