Provider Demographics
NPI:1316559081
Name:PROCARE HOSPICE OF NEVADA, LLC
Entity Type:Organization
Organization Name:PROCARE HOSPICE OF NEVADA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-380-8300
Mailing Address - Street 1:8025 AMIGO ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1210
Mailing Address - Country:US
Mailing Address - Phone:702-380-8300
Mailing Address - Fax:
Practice Address - Street 1:8025 AMIGO ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1210
Practice Address - Country:US
Practice Address - Phone:702-380-8300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROCARE HOSPICE OF NEVADA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-23
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty