Provider Demographics
NPI:1669814661
Name:HOMETRUST HEALTHCARE, LLC
Entity Type:Organization
Organization Name:HOMETRUST HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LABINPUNO
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:702-948-8919
Mailing Address - Street 1:4535 W SAHARA AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102
Mailing Address - Country:US
Mailing Address - Phone:702-948-8919
Mailing Address - Fax:702-413-7701
Practice Address - Street 1:4535 W SAHARA AVE STE 211
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-3710
Practice Address - Country:US
Practice Address - Phone:702-948-8919
Practice Address - Fax:702-413-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7627PCS-0253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care