Provider Demographics
NPI:1427366699
Name:JIREH HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:JIREH HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMEO
Authorized Official - Middle Name:A
Authorized Official - Last Name:SEDANO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:702-359-1388
Mailing Address - Street 1:2320 PASEO DEL PRADO
Mailing Address - Street 2:SUITE B101
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-0048
Mailing Address - Country:US
Mailing Address - Phone:702-359-1388
Mailing Address - Fax:702-359-2388
Practice Address - Street 1:2320 PASEO DEL PRADO
Practice Address - Street 2:SUITE B101
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-0048
Practice Address - Country:US
Practice Address - Phone:702-359-1388
Practice Address - Fax:702-359-2388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-21
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVH14-00300-H-151012251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based