Life Care Home Health Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

4603HHA-0 Issued in NV

Legal business name

LIFE CARE HOME HEALTH INC

Practice address

3017 W Charleston Blvd Ste 15
Las Vegas, NV 89102-1927

Phone

(702) 363-9775

Fax

(702) 363-9776

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Benedick Cabrera, RN

Title

Assistant Administrator

Phone

(702) 363-9775

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Home health agency certification: CCN 297152

Legal name

LIFE CARE HOME HEALTH INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jul 28, 2008

Last certification

Oct 16, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Mar 8, 2006 in NV

Enrollment address

3017 W Charleston Blvd
Ste 15
Las Vegas, NV 89102-1927

Listed as

Life Care Home Health IncCCN 297152

Overall star rating

3.5 of 5

Ownership

Proprietary

Certified

Jul 28, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 4

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Arnold Debelen, MD

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1205852654

  Corporate Director

  CMS ownership

Practitioners 1

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

• Abegail Concon, APRN, FNP-C

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1053767335
  NPD

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Mylene Agreda

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1568031235

  Home health agency

  Care Compare affiliation
• Arnold Debelen, MD

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1205852654

  Home health agency

  Care Compare affiliation
• Michael B Jacobs, M.D., PH.D.

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1053300913

  Home health agency

  Care Compare affiliation
• Nikesha Mobley, DNP, APRN-CNP

  • Acute Care Nurse Practitioner
  • Henderson, NV
  • NPI 1902384472

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323820800000",
    "number": "1720290653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 W CHARLESTON BLVD STE 15",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021927",
            "telephone_number": "702-363-9775",
            "fax_number": "702-363-9776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 W CHARLESTON BLVD STE 15",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021927",
            "telephone_number": "702-363-9775",
            "fax_number": "702-363-9776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CARE HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2011-12-14",
        "status": "A",
        "authorized_official_last_name": "CABRERA",
        "authorized_official_first_name": "BENEDICK",
        "authorized_official_title_or_position": "ASSISTANT ADMINISTRATOR",
        "authorized_official_telephone_number": "702-363-9775",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NV",
            "license": "4603HHA-0",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "4603HHA-0",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trinh Anh Lieu
• Life Adult Day Care LLC
• Life Align Chiropractic LLC
• Life Aligned Therapy LLC
• Life Care at Home of Nevada, Inc
• Life Care Hospice LLC
• Life Changing LLC
• Life Changing Solutions
• Life Changing Solutions
• Life Changing Solutions

• Home Health Agency in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Home Health Agency in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.