Provider Demographics
NPI:1013337195
Name:KAREN'S CAREGIVER HOME
Entity Type:Organization
Organization Name:KAREN'S CAREGIVER HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-808-3581
Mailing Address - Street 1:5713 EUGENE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-6206
Mailing Address - Country:US
Mailing Address - Phone:702-808-3581
Mailing Address - Fax:702-648-8910
Practice Address - Street 1:5713 EUGENE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-6206
Practice Address - Country:US
Practice Address - Phone:702-808-3581
Practice Address - Fax:702-648-8910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3577HIC-12305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization