Native Home Health Care, LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

116513 Issued in NV

Legal business name

NATIVE HOME HEALTH CARE, LLC

Practice address

2235 E Flamingo Rd
Suite C-7
Las Vegas, NV 89119-5129

Phone

(702) 862-4177

Fax

(702) 862-4185

NPI assigned

Mar 22, 2006

Organization subpart

No

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

Authorized official

Name

Angel Jackson, ADMINISTRATOR

Title

Owner

Phone

(702) 862-4177

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1336108810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 E FLAMINGO RD",
            "address_2": "SUITE C-7",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195129",
            "telephone_number": "702-862-4177",
            "fax_number": "702-862-4185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 E FLAMINGO RD",
            "address_2": "SUITE C-7",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195129",
            "telephone_number": "702-862-4177",
            "fax_number": "702-862-4185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIVE HOME HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-862-4177",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NV",
            "license": "116513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100504839",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.