Provider Demographics
NPI:1417474867
Name:NURSES CARE HOME HEALTH LLC
Entity Type:Organization
Organization Name:NURSES CARE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:REBOLLEDO
Authorized Official - Last Name:AGUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:702-410-2616
Mailing Address - Street 1:8290 W SAHARA AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8937
Mailing Address - Country:US
Mailing Address - Phone:702-410-2616
Mailing Address - Fax:702-938-4109
Practice Address - Street 1:8290 W SAHARA AVE STE 210
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-8937
Practice Address - Country:US
Practice Address - Phone:702-410-2616
Practice Address - Fax:702-938-4109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-26
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20171307704251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNV20171307704OtherBUSINESS LICENSE