Provider Demographics
NPI:1578189312
Name:NEVADA HOME CARE, LLC
Entity type:Organization
Organization Name:NEVADA HOME CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRACY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-266-6683
Mailing Address - Street 1:2501 N GREEN VALLEY PKWY STE 118
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-2158
Mailing Address - Country:US
Mailing Address - Phone:702-476-8809
Mailing Address - Fax:
Practice Address - Street 1:2501 N GREEN VALLEY PKWY STE 118
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-2158
Practice Address - Country:US
Practice Address - Phone:702-476-8809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEVADA HOME CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-17
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care