Provider Demographics
NPI:1417548314
Name:RADIANT HOSPICE OF NEVADA LLC
Entity Type:Organization
Organization Name:RADIANT HOSPICE OF NEVADA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNA
Authorized Official - Suffix:JR
Authorized Official - Credentials:RN
Authorized Official - Phone:702-850-9004
Mailing Address - Street 1:5600 SPRING MOUNTAIN RD STE 206
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-8823
Mailing Address - Country:US
Mailing Address - Phone:702-850-9004
Mailing Address - Fax:
Practice Address - Street 1:5600 SPRING MOUNTAIN RD STE 206
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-8823
Practice Address - Country:US
Practice Address - Phone:702-850-9004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based