Angel'S Palm LLC

Organization Active NPI Community Based Hospice Care Agency · Las Vegas, NV

NPI 1831972256 · NPPES record last updated Sep 26, 2023

Key facts

NPI
1831972256
Entity type
Organization (NPI type 2)
Primary specialty
Community Based Hospice Care Agency 251G00000X
Legal business name
ANGEL'S PALM LLC
Practice address
8683 W Sahara Ave Ste 220
Las Vegas, NV 89117-5884
Phone
(702) 772-2507
Fax
(702) 268-7078
NPI assigned
Aug 17, 2023
Organization subpart
Yes
Parent organization (as reported)
ANGEL'S PALM LLC

Authorized official

Name
Roman Caballero
Title
Administrator
Phone
(702) 350-9013

Owners & managing parties with NPI records 1

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

Practitioners 1

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

Medicare Care Compare: Hospice

Listed as
Angel'S Palm Hospice Care CCN 291714
Certified
May 29, 2025
Medicare certification status
Active (Provider of Services file)

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NV

Hospice certification: CCN 291714

Legal name
ANGELS PALM LLC
Doing business as
ANGELS PALM HOSPICE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 29, 2025
Last certification
May 15, 2025
Organization structure
LLC · Proprietary
Enrollment address
8683 W Sahara Ave
Ste 220
Las Vegas, NV 89117-5884

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Roman Caballero
Individual
5% Or Greater Direct Ownership Interest
Administrator
Nov 22, 2022 100%
5% Or Greater Security Interest
Administrator
Nov 22, 2022 100%
Corporate Officer
Adminstrator
Nov 22, 2022 100%
Corporate Director
Adminstrator
Nov 22, 2022 100%
W-2 Managing Employee
Ad;
Nov 22, 2022 100%
Jeartha Caballero
Individual
Corporate Officer
DPCS
Dec 1, 2022
Corporate Director
DPCS
Dec 1, 2022
W-2 Managing Employee
DPCS
Dec 1, 2022
Chukwuemeka O Iroha
Individual
Contracted Managing Employee
MD;
Oct 31, 2025

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240930001771 NV Part a Provider - Hospice 8426589680 Practice locations: Las Vegas, NV

National Provider Directory

Part of
Angels Palm LLC

Locations

8683 W Sahara Ave
Ste 220
Las Vegas, NV 89117
Phone (702) 369-3338

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Yes

Addresses

Primary practice location

8683 W Sahara Ave Ste 220
Las Vegas, NV 89117-5884

Mailing address

8683 W Sahara Ave Ste 220
Las Vegas, NV 89117-5884
Phone (702) 772-2507

Other names

  • Angel's Palm Hospice Care Doing business as

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Community Based Hospice Care Agency in Nevada

Sources for this page

Verify at the official NPI Registry.