Provider Demographics
NPI:1780012393
Name:SELECT HOME CARE
Entity Type:Organization
Organization Name:SELECT HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMAHON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-240-2273
Mailing Address - Street 1:9960 W CHEYENNE AVE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7701
Mailing Address - Country:US
Mailing Address - Phone:702-240-2273
Mailing Address - Fax:702-442-7170
Practice Address - Street 1:9960 W CHEYENNE AVE
Practice Address - Street 2:SUITE 160
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7701
Practice Address - Country:US
Practice Address - Phone:702-240-2273
Practice Address - Fax:702-442-7170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5655PCS5251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health