Provider Demographics
NPI:1326280439
Name:HOME BOUND HEALTHCARE NEVADA, INC.
Entity Type:Organization
Organization Name:HOME BOUND HEALTHCARE NEVADA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:KALKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-433-0800
Mailing Address - Street 1:1350 S JONES BLVD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-1206
Mailing Address - Country:US
Mailing Address - Phone:702-433-0800
Mailing Address - Fax:702-433-0801
Practice Address - Street 1:1350 S JONES BLVD
Practice Address - Street 2:SUITE 240
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1206
Practice Address - Country:US
Practice Address - Phone:702-433-0800
Practice Address - Fax:702-433-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-03
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5607HHA-0251E00000X
NV29D1097507291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No291U00000XLaboratoriesClinical Medical Laboratory