Provider Demographics
NPI:1780101378
Name:SOLACE PEDIATRIC HEALTHCARE NURSING SERVICES, NV, LLC
Entity type:Organization
Organization Name:SOLACE PEDIATRIC HEALTHCARE NURSING SERVICES, NV, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:INDIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHABIR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:954-260-3282
Mailing Address - Street 1:250 PILOT RD STE 250
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-3514
Mailing Address - Country:US
Mailing Address - Phone:702-982-3292
Mailing Address - Fax:702-982-5286
Practice Address - Street 1:250 PILOT RD STE 250
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-3514
Practice Address - Country:US
Practice Address - Phone:702-982-3292
Practice Address - Fax:702-982-5286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health