Provider Demographics
NPI:1891356770
Name:ANCHOR HOMECARE LLC
Entity Type:Organization
Organization Name:ANCHOR HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MADISON
Authorized Official - Suffix:
Authorized Official - Credentials:PCA
Authorized Official - Phone:702-686-4698
Mailing Address - Street 1:3151 SOARING GULLS DR UNIT 2058
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7037
Mailing Address - Country:US
Mailing Address - Phone:702-686-4698
Mailing Address - Fax:
Practice Address - Street 1:1508 WINWOOD ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-1575
Practice Address - Country:US
Practice Address - Phone:702-686-4698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-22
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1841704137OtherMY NPI NUMBER