Provider Demographics
NPI:1922259167
Name:AT HOME PERSONAL CARE
Entity Type:Organization
Organization Name:AT HOME PERSONAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SWARTWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-746-5558
Mailing Address - Street 1:1500 E TROPICANA AVE STE 131
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6503
Mailing Address - Country:US
Mailing Address - Phone:702-736-7547
Mailing Address - Fax:
Practice Address - Street 1:1500 E TROPICANA AVE STE 131
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6503
Practice Address - Country:US
Practice Address - Phone:702-736-7547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2000218-571251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health