Pearl Care Home LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

PEARL CARE HOME LLC

Practice address

1012 Paradise View St
Henderson, NV 89052-3937

Phone

(702) 614-7059

Fax

(702) 614-1247

NPI assigned

Dec 12, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Roy Deguzman Desamito

Title

Managing Member / Manager

Phone

(702) 807-9971

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670803200000",
    "number": "1336850361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 PARADISE VIEW ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523937",
            "telephone_number": "702-614-7059",
            "fax_number": "702-614-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 PARADISE VIEW ST",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890523937",
            "telephone_number": "702-614-7059",
            "fax_number": "702-614-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "DESAMITO",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "DEGUZMAN",
        "authorized_official_title_or_position": "MANAGING MEMBER / MANAGER",
        "authorized_official_telephone_number": "702-807-9971",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Henderson, NV
• Providers in Henderson, NV by specialty
• Adult Care Home Facility in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.