Providence Healthcare of Nevada LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PROVIDENCE HEALTHCARE OF NEVADA LLC

Practice address

5510 S Fort Apache Rd
Ste 18
Las Vegas, NV 89148-7700

Phone

(702) 680-0235

Fax

(702) 680-0236

NPI assigned

May 2, 2017

Last updated

May 2, 2017By 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

Mr. Gerard M Tabora

Title

Administrator

Phone

(702) 680-0235

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493683200000",
    "number": "1750817441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5510 S FORT APACHE RD",
            "address_2": "STE 18",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891487700",
            "telephone_number": "702-680-0235",
            "fax_number": "702-680-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 S FORT APACHE RD",
            "address_2": "STE 18",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891487700",
            "telephone_number": "702-680-0235",
            "fax_number": "702-680-0236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HEALTHCARE OF NEVADA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-02",
        "last_updated": "2017-05-02",
        "status": "A",
        "authorized_official_last_name": "TABORA",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-680-0235",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 May 2, 2017; 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.