Provider Demographics
NPI:1619393030
Name:SALUBRITY HOME HEALTH CARE
Entity Type:Organization
Organization Name:SALUBRITY HOME HEALTH CARE
Other - Org Name:SALUBRITY HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:C
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:QMHA
Authorized Official - Phone:702-812-1019
Mailing Address - Street 1:6259 COPPER LIGHT ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-6408
Mailing Address - Country:US
Mailing Address - Phone:702-812-1079
Mailing Address - Fax:
Practice Address - Street 1:5135 CAMINO AL NOTRE
Practice Address - Street 2:287
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-2373
Practice Address - Country:US
Practice Address - Phone:702-812-1079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20121145588251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health