Charmed Home Health Care Services LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1007715014 Issued in NV

Legal business name

CHARMED HOME HEALTH CARE SERVICES LLC

Practice address

6201 E Lake Mead Blvd
Unit 104
Las Vegas, NV 89156-6990

Phone

(702) 438-5335

Fax

(702) 438-5335

NPI assigned

Jan 21, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Jo Mattio Katsoris

Title

Owner/Care Giver

Phone

(702) 426-5959

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232496000000",
    "number": "1730326224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 E LAKE MEAD BLVD",
            "address_2": "UNIT 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891566990",
            "telephone_number": "702-438-5335",
            "fax_number": "702-438-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 E LAKE MEAD BLVD",
            "address_2": "UNIT 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891566990",
            "telephone_number": "702-438-5335",
            "fax_number": "702-438-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARMED HOME HEALTH CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-21",
        "last_updated": "2009-01-21",
        "status": "A",
        "authorized_official_last_name": "MATTIO KATSORIS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OWNER/CARE GIVER",
        "authorized_official_telephone_number": "702-426-5959",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NV",
            "license": "1007715014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Skilled Nursing Facility in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; 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.