Provider Demographics
NPI:1982359469
Name:LIFESPAN HOSPICE CARE INC
Entity Type:Organization
Organization Name:LIFESPAN HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NINEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TER-ANDRIASYANTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:725-433-1177
Mailing Address - Street 1:1555 E FLAMINGO RD # F-129
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5258
Mailing Address - Country:US
Mailing Address - Phone:725-433-1177
Mailing Address - Fax:725-433-1178
Practice Address - Street 1:1555 E FLAMINGO RD # F-129
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5258
Practice Address - Country:US
Practice Address - Phone:725-433-1177
Practice Address - Fax:725-433-1178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based