Provider Demographics
NPI:1558050773
Name:EXCELLENCE HOME CARE LLC
Entity Type:Organization
Organization Name:EXCELLENCE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASTGHIK
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGHATELYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-786-7379
Mailing Address - Street 1:620 CRAGIN PARK DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-4313
Mailing Address - Country:US
Mailing Address - Phone:702-350-1672
Mailing Address - Fax:
Practice Address - Street 1:620 CRAGIN PARK DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-4313
Practice Address - Country:US
Practice Address - Phone:702-350-1672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty