Provider Demographics
NPI:1851994560
Name:PRECIOUS HEARTS HEALTH CARE PROVIDERS, LLC
Entity Type:Organization
Organization Name:PRECIOUS HEARTS HEALTH CARE PROVIDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BENISON
Authorized Official - Middle Name:F
Authorized Official - Last Name:SAHAGUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-888-1712
Mailing Address - Street 1:6525 W WARM SPRINGS RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-4679
Mailing Address - Country:US
Mailing Address - Phone:702-888-1712
Mailing Address - Fax:725-777-3897
Practice Address - Street 1:6525 W WARM SPRINGS RD STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-4679
Practice Address - Country:US
Practice Address - Phone:702-888-1712
Practice Address - Fax:725-777-3897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Single Specialty