Provider Demographics
NPI:1770529984
Name:VIP HOME HEALTH, INC
Entity type:Organization
Organization Name:VIP HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SABALONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-880-3847
Mailing Address - Street 1:3100 W CHARLESTON BLVD
Mailing Address - Street 2:STE 208
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1900
Mailing Address - Country:US
Mailing Address - Phone:702-880-3847
Mailing Address - Fax:702-880-3848
Practice Address - Street 1:3100 W CHARLESTON BLVD
Practice Address - Street 2:STE 208
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1900
Practice Address - Country:US
Practice Address - Phone:702-880-3847
Practice Address - Fax:702-880-3848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3872HHA-10251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV297108Medicare Oscar/Certification