Provider Demographics
NPI:1609501097
Name:SACRED HEART LLC
Entity Type:Organization
Organization Name:SACRED HEART LLC
Other - Org Name:SACRED HEART HOSPICE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:RETIRADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-321-6145
Mailing Address - Street 1:3311 S RAINBOW BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-6596
Mailing Address - Country:US
Mailing Address - Phone:725-247-0388
Mailing Address - Fax:
Practice Address - Street 1:3311 S RAINBOW BLVD STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6596
Practice Address - Country:US
Practice Address - Phone:725-247-0388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-19
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based