Provider Demographics
NPI:1881064194
Name:TRANSITIONAL CARE ASSOCIATES AT HOME
Entity type:Organization
Organization Name:TRANSITIONAL CARE ASSOCIATES AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KOZLOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-450-1717
Mailing Address - Street 1:500 N RAINBOW BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-1082
Mailing Address - Country:US
Mailing Address - Phone:702-450-1717
Mailing Address - Fax:702-947-6740
Practice Address - Street 1:500 N RAINBOW BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-1082
Practice Address - Country:US
Practice Address - Phone:702-450-1717
Practice Address - Fax:702-947-6740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20151504380253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care