Provider Demographics
NPI:1619469632
Name:A BETTER LIFE IN HOME CARE, LLC
Entity Type:Organization
Organization Name:A BETTER LIFE IN HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-722-1229
Mailing Address - Street 1:4550 W OAKEY BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1506
Mailing Address - Country:US
Mailing Address - Phone:702-722-1229
Mailing Address - Fax:702-442-7770
Practice Address - Street 1:4550 W OAKEY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1506
Practice Address - Country:US
Practice Address - Phone:702-722-1229
Practice Address - Fax:702-442-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1215436563Medicaid