Provider Demographics
NPI:1821444662
Name:BLISS HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:BLISS HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:OCTAVIO
Authorized Official - Last Name:BUSTIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-303-0696
Mailing Address - Street 1:PO BOX 530001
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89053-0001
Mailing Address - Country:US
Mailing Address - Phone:702-303-0696
Mailing Address - Fax:
Practice Address - Street 1:8670 W CHEYENNE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-7456
Practice Address - Country:US
Practice Address - Phone:702-430-4721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8556-PCS-0251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health