Provider Demographics
NPI:1922592385
Name:RED ROCK HOSPICE
Entity Type:Organization
Organization Name:RED ROCK HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RASTELLI
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:REGALADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-540-7707
Mailing Address - Street 1:1811 S RAINBOW BLVD STE 215
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-0855
Mailing Address - Country:US
Mailing Address - Phone:702-540-7707
Mailing Address - Fax:702-924-5052
Practice Address - Street 1:1811 S RAINBOW BLVD STE 215
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-0855
Practice Address - Country:US
Practice Address - Phone:702-540-7707
Practice Address - Fax:702-924-5052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8861-HPC-0251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based