Provider Demographics
NPI:1326559345
Name:LAS VEGAS HEALTH CARE,LLC LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:LAS VEGAS HEALTH CARE,LLC LIMITED LIABILITY COMPANY
Other - Org Name:HOME HEALTH CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARIFA
Authorized Official - Middle Name:G
Authorized Official - Last Name:WAHAB
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:702-234-9088
Mailing Address - Street 1:6290 S RAINBOW BLVD STE 9
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-3246
Mailing Address - Country:US
Mailing Address - Phone:702-410-8018
Mailing Address - Fax:702-410-8018
Practice Address - Street 1:6290 S RAINBOW BLVD STE 9
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-3246
Practice Address - Country:US
Practice Address - Phone:702-410-8018
Practice Address - Fax:702-410-8018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-17
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care