Provider Demographics
NPI:1326084260
Name:INTERIM HEALTHCARE OF NEVADA, INC.
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF NEVADA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:FEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-369-5533
Mailing Address - Street 1:5506 S FORT APACHE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-7672
Mailing Address - Country:US
Mailing Address - Phone:702-369-5533
Mailing Address - Fax:702-242-4769
Practice Address - Street 1:5506 S FORT APACHE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-7672
Practice Address - Country:US
Practice Address - Phone:702-369-5533
Practice Address - Fax:702-242-4769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV564HHA15251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002902024Medicaid
NV297095Medicare Oscar/Certification