Provider Demographics
NPI:1851639132
Name:WELLCARE HOME HEALTH INC.
Entity Type:Organization
Organization Name:WELLCARE HOME HEALTH INC.
Other - Org Name:WELLCARE HOME HEALTH INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:
Authorized Official - Last Name:SUENO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:702-476-3394
Mailing Address - Street 1:3110 S VALLEY VIEW BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-8389
Mailing Address - Country:US
Mailing Address - Phone:702-476-3394
Mailing Address - Fax:702-733-6029
Practice Address - Street 1:3110 S VALLEY VIEW BLVD STE 204
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-8389
Practice Address - Country:US
Practice Address - Phone:702-476-3394
Practice Address - Fax:702-733-6029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6304HHA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health