Provider Demographics
NPI:1114311503
Name:HOSPICE SERVICES OF NEVADA INC
Entity type:Organization
Organization Name:HOSPICE SERVICES OF NEVADA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CUDIAMAT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:702-222-1714
Mailing Address - Street 1:3100 W SAHARA AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-6001
Mailing Address - Country:US
Mailing Address - Phone:702-222-1714
Mailing Address - Fax:702-222-1715
Practice Address - Street 1:3100 W SAHARA AVE STE 112
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-6001
Practice Address - Country:US
Practice Address - Phone:702-222-1714
Practice Address - Fax:702-222-1715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8005HPC0251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based