Provider Demographics
NPI:1528414331
Name:HEALTH TO NEVADA, LLC
Entity Type:Organization
Organization Name:HEALTH TO NEVADA, LLC
Other - Org Name:HEALTH TO YOU
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:M
Authorized Official - Last Name:BANNISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-772-7551
Mailing Address - Street 1:4346 CRIMSON TIDE AVE
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-0446
Mailing Address - Country:US
Mailing Address - Phone:702-405-8392
Mailing Address - Fax:702-489-3013
Practice Address - Street 1:4346 CRIMSON TIDE AVE
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-0446
Practice Address - Country:US
Practice Address - Phone:702-405-8392
Practice Address - Fax:702-489-3013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8302PCS-0251S00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1619336864OtherNPI - PROVIDER TYPE 58
NV1568850204OtherNPI - PROVIDER TYPE 30