Provider Demographics
NPI:1760838700
Name:ALTA CARE HOSPICE AND PALLIATIVE CARE INC.
Entity Type:Organization
Organization Name:ALTA CARE HOSPICE AND PALLIATIVE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILMER
Authorized Official - Middle Name:AQUINO
Authorized Official - Last Name:COMAHIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-522-8803
Mailing Address - Street 1:6280 S VALLEY VIEW BLVD STE 122
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-3814
Mailing Address - Country:US
Mailing Address - Phone:702-522-8803
Mailing Address - Fax:702-522-9483
Practice Address - Street 1:6280 S VALLEY VIEW BLVD STE 122
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-3814
Practice Address - Country:US
Practice Address - Phone:702-522-8803
Practice Address - Fax:702-522-9483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based