NPIMap

Organization Active NPI

Lifecare, LLC.

  • Community Based Hospice Care Agency
  • Las Vegas, NV
National Provider Identifier
1649844200
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
LIFECARE, LLC.
Practice address
1180 N Town Center Dr Ste 100
Las Vegas, NV 89144-6308
Phone
(702) 769-2781
Fax
(725) 214-6529
NPI assigned
May 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Authorized official

Name
Kathleen MaravillasNPI 1689047623
Title
Administrator
Phone
(702) 769-2781

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WH1000X
Community Based Hospice Care Agency 251G00000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1180 N Town Center Dr Ste 100
Las Vegas, NV 89144-6308

Mailing address

1180 N Town Center Dr Ste 100
Las Vegas, NV 89144-6308
Phone (702) 769-2781

Other names 1

  • LifeCare Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230601001855 NV Part A Provider - Hospice 2860859113 Practice locations: Las Vegas, NV

Hospice certification: CCN 291694

Legal name
LIFECARE, LLC.
Doing business as
LIFECARE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 20, 2024
Last certification
Dec 5, 2024
Organization structure
LLCProprietary
Incorporated
Feb 26, 2021 in NV
Enrollment address
1180 N Town Center Dr
Ste 100
Las Vegas, NV 89144-6308

Care Compare: Hospice

Medicare Care Compare
Listed as
Lifecare HospiceCCN 291694
Certified
Dec 20, 2024
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kathleen Maravillas Individual Contracted Managing EmployeeCeo/President Apr 1, 2021 100%
5% Or Greater Direct Ownership InterestCeo/President Apr 1, 2021 100%
W-2 Managing EmployeeCeo/President Apr 1, 2021 100%
Operational/Managerial ControlCeo/President Apr 1, 2021 100%

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1649844200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 N TOWN CENTER DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891446308",
            "telephone_number": "702-769-2781",
            "fax_number": "725-214-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 N TOWN CENTER DR STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891446308",
            "telephone_number": "702-769-2781",
            "fax_number": "725-214-6529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECARE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "MARAVILLAS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-769-2781"
    },
    "taxonomies": [
        {
            "code": "163WH1000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Hospice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeCare Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.