Provider Demographics
NPI:1396364600
Name:PACESETTERS HOME HEALTH LLC
Entity Type:Organization
Organization Name:PACESETTERS HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:GWENDOLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NFOTIOG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-490-7531
Mailing Address - Street 1:2870 EASTMINSTER DR
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-1436
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2870 EASTMINSTER DR
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-1436
Practice Address - Country:US
Practice Address - Phone:702-490-7531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-16
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care