Organization Active NPI

Procare Home Health LLC

  • Home Health Agency
  • Las Vegas, NV
National Provider Identifier
1942954896
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PROCARE HOME HEALTH LLC
Practice address
6655 W Sahara Ave Ste D110
Las Vegas, NV 89146-0846
Phone
(702) 372-8140
NPI assigned
Feb 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Authorized official

Name
Tadesse Kebede
Title
Owner/President
Phone
(702) 372-8140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

6655 W Sahara Ave Ste D110
Las Vegas, NV 89146-0846

Mailing address

6655 W Sahara Ave Ste D110
Las Vegas, NV 89146-0846
Phone (702) 372-8140

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230224000466 NV Part A Provider - Home Health Agency 0749653699 Practice locations: Las Vegas, NV

Home health agency certification: CCN 297340

Legal name
PROCARE HOME HEALTH LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 1, 2024
Last certification
Feb 1, 2024
Organization structure
LLCProprietary
Incorporated
Feb 9, 2022 in VA
Enrollment address
6655 W Sahara Ave
Ste D110
Las Vegas, NV 89146-0846

Care Compare: Home health agency

Medicare Care Compare
Listed as
Procare Home Health LLCCCN 297340
Overall star rating
3.5 of 5
Ownership
-
Certified
Feb 1, 2024
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2269557Procare Home Health LLC6655 W Sahara Ave Suite D110, Las Vegas, NV 89146Certificate of waiverSep 27, 2026

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
Tadesse Kebede Individual 5% Or Greater Direct Ownership InterestPresident/Administrator Feb 9, 2022 100%
Corporate DirectorPresident/Administrator Feb 9, 2022 100%
W-2 Managing EmployeePresident/Administrator Feb 9, 2022 100%

Practitioners & affiliated clinicians

Affiliated clinicians 5

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

NPI Registry JSON

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

{
    "created_epoch": "1644364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644364800000",
    "number": "1942954896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6655 W SAHARA AVE STE D110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891460846",
            "telephone_number": "702-372-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 W SAHARA AVE STE D110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891460846",
            "telephone_number": "702-372-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCARE HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A",
        "authorized_official_last_name": "KEBEDE",
        "authorized_official_first_name": "TADESSE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "702-372-8140"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.