Provider Demographics
NPI:1790019131
Name:LUTHERAN SOCIAL SERVICES OF NEVADA
Entity Type:Organization
Organization Name:LUTHERAN SOCIAL SERVICES OF NEVADA
Other - Org Name:ANGELS OF CARE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ARMENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MKHITARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:702-639-1730
Mailing Address - Street 1:73 SPECTRUM BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-4838
Mailing Address - Country:US
Mailing Address - Phone:702-639-1730
Mailing Address - Fax:702-639-1736
Practice Address - Street 1:73 SPECTRUM BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-4838
Practice Address - Country:US
Practice Address - Phone:702-639-1730
Practice Address - Fax:702-639-1736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV251S00000X
NV5948PCS-4305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No305S00000XManaged Care OrganizationsPoint of Service