Provider Demographics
NPI:1639147051
Name:NATHAN ADELSON HOSPICE INC
Entity Type:Organization
Organization Name:NATHAN ADELSON HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-796-3112
Mailing Address - Street 1:4131 UNIVERSITY CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6718
Mailing Address - Country:US
Mailing Address - Phone:027-330-3207
Mailing Address - Fax:702-796-3152
Practice Address - Street 1:4131 UNIVERSITY CENTER DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6718
Practice Address - Country:US
Practice Address - Phone:702-733-0320
Practice Address - Fax:702-796-3152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20090616100099350207LH0002X
207LH0002X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Single Specialty
No207LH0002XAllopathic & Osteopathic PhysiciansAnesthesiologyHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018461Medicaid
NV002018461Medicaid
NV002019054Medicaid
NV002012042Medicaid
NV100500176Medicaid
NVH22167Medicare UPIN
NVG01213Medicare UPIN
NV100500176Medicaid
NV002019054Medicaid
P48163Medicare UPIN
NVA75359Medicare UPIN
NV002012042Medicaid