Provider Demographics
NPI:1568726867
Name:COMPREHENSIVE HEALTH CARE LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE HEALTH CARE LLC
Other - Org Name:GOLDEN HOME HEALTH NEVADA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:AVILA
Authorized Official - Last Name:OTTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-778-8365
Mailing Address - Street 1:3750 S JONES BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-2209
Mailing Address - Country:US
Mailing Address - Phone:702-778-8365
Mailing Address - Fax:702-778-3368
Practice Address - Street 1:3750 S JONES BLVD STE 160
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2209
Practice Address - Country:US
Practice Address - Phone:702-778-8365
Practice Address - Fax:702-778-3368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-02
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6181HHA-0251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV297203Medicare Oscar/Certification