Provider Demographics
NPI:1154009827
Name:HOLLISTIC HOSPICE OF LAS VEGAS LLC
Entity type:Organization
Organization Name:HOLLISTIC HOSPICE OF LAS VEGAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PULIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-635-7443
Mailing Address - Street 1:8987 WEST FLAMINGO ROAD, BLDG 105, SUITE N 103
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-0437
Mailing Address - Country:US
Mailing Address - Phone:702-635-7443
Mailing Address - Fax:
Practice Address - Street 1:8987 W FLAMINGO RD, BLDG 105 SUITE N 103
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-0437
Practice Address - Country:US
Practice Address - Phone:702-550-0177
Practice Address - Fax:702-551-5102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based