Provider Demographics
NPI:1659425783
Name:AFTERCARE OF NEVADA, INC.
Entity Type:Organization
Organization Name:AFTERCARE OF NEVADA, INC.
Other - Org Name:IN-HOUSE EXTENDED CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:SIDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-894-9449
Mailing Address - Street 1:3075 E FLAMINGO RD
Mailing Address - Street 2:SUITE 116A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-7483
Mailing Address - Country:US
Mailing Address - Phone:702-894-9449
Mailing Address - Fax:
Practice Address - Street 1:3075 E FLAMINGO RD
Practice Address - Street 2:SUITE 116A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-7483
Practice Address - Country:US
Practice Address - Phone:702-894-9449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV561HHA-16251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2902006Medicaid
NV2902006Medicaid