Provider Demographics
NPI:1629022074
Name:COMPASSIONCARE HOSPICE LAS VEGAS, LLC
Entity Type:Organization
Organization Name:COMPASSIONCARE HOSPICE LAS VEGAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSLOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-576-0087
Mailing Address - Street 1:7842 W. SAHARA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117
Mailing Address - Country:US
Mailing Address - Phone:702-636-0200
Mailing Address - Fax:702-636-2208
Practice Address - Street 1:7842 W. SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117
Practice Address - Country:US
Practice Address - Phone:702-636-0200
Practice Address - Fax:702-636-2208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV251G00000X251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV291516Medicare ID - Type Unspecified