Provider Demographics
NPI:1023839958
Name:MOUNT CARMEL HOME HEALTH LLC
Entity type:Organization
Organization Name:MOUNT CARMEL HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RYAN MICHAEL AGCAOIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-752-9178
Mailing Address - Street 1:2626 S RAINBOW BLVD
Mailing Address - Street 2:203C
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146
Mailing Address - Country:US
Mailing Address - Phone:702-330-0601
Mailing Address - Fax:702-462-2362
Practice Address - Street 1:2626 S RAINBOW BLVD
Practice Address - Street 2:203C
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146
Practice Address - Country:US
Practice Address - Phone:702-330-0601
Practice Address - Fax:702-462-2362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health