Addus Healthcare Inc

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

5427PCS8 Issued in NV

Legal business name

ADDUS HEALTHCARE INC

Doing business as

Desert PCA

Practice address

6128 W Sahara Ave
Room a
Las Vegas, NV 89146-3051

Phone

(702) 359-3105

Fax

(702) 598-2041

NPI assigned

Apr 10, 2006

Last updated

Nov 29, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Diane Kumarich, RN, MS, MBA

Title

National Contracts

Phone

(630) 296-3400

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Desert PCA Doing business as

Locations

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480377600000",
    "number": "1366405227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 WARRENVILLE RD",
            "address_2": "SUITE 100",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151765",
            "telephone_number": "630-296-3400",
            "fax_number": "630-487-2713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6128 W SAHARA AVE",
            "address_2": "ROOM A",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463051",
            "telephone_number": "702-359-3105",
            "fax_number": "702-598-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDUS HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2016-11-29",
        "status": "A",
        "authorized_official_last_name": "KUMARICH",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "NATIONAL CONTRACTS",
        "authorized_official_telephone_number": "630-296-3400",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, MS, MBA"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NV",
            "license": "5427PCS8",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100505778",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert PCA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Addison Holdings, Inc. (Hillside Manor at Mountains Edge)
• George Richard Addison III, M.S. ED.
• Keith Addison
• Bernard K. Addo-Quaye, M.D.
• Addus Healthcare (Nevada), Inc. (SuCasa Personal Care)
• Susan Addy
• Adeola Serifat Adebayo
• Peter Adedirary
• Oluwagbemileke Ayodeji Adedotun, DNP, APRN, PMHNP-BC
• Oluyemisi Olayinka Adedotun, APRN

• In Home Supportive Care Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• In Home Supportive Care Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.