Provider Demographics
NPI:1619388055
Name:SAHARA HOME HEALTH
Entity Type:Organization
Organization Name:SAHARA HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-902-2411
Mailing Address - Street 1:4560 S DECATUR BLVD
Mailing Address - Street 2:STE 303
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-5251
Mailing Address - Country:US
Mailing Address - Phone:702-902-2411
Mailing Address - Fax:702-920-8224
Practice Address - Street 1:4560 S DECATUR BLVD
Practice Address - Street 2:STE 303
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-5251
Practice Address - Country:US
Practice Address - Phone:702-902-2411
Practice Address - Fax:702-920-8224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1016327242251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health