Organization Active NPI

Desert Blossom Home Care LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Las Vegas, NV
National Provider Identifier
1194620179
Registry record updated Oct 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
DESERT BLOSSOM HOME CARE LLC
Practice address
6657 Pleasant Plains Way
Las Vegas, NV 89108-5317
Phone
(818) 927-5169
NPI assigned
Oct 10, 2026
Last updated
Oct 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Hawi Tesfaye Grady
Title
Owner
Phone
(818) 927-5169

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

6657 Pleasant Plains Way
Las Vegas, NV 89108-5317

Mailing address

6657 Pleasant Plains Way
Las Vegas, NV 89108-5317
Phone (818) 927-5169

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1791590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791590400000",
    "number": "1194620179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6657 PLEASANT PLAINS WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891085317",
            "telephone_number": "818-927-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6657 PLEASANT PLAINS WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891085317",
            "telephone_number": "818-927-5169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT BLOSSOM HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-10",
        "last_updated": "2026-10-10",
        "certification_date": "2026-10-10",
        "status": "A",
        "authorized_official_last_name": "GRADY",
        "authorized_official_first_name": "HAWI",
        "authorized_official_middle_name": "TESFAYE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-927-5169"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.