Provider Demographics
NPI:1124695911
Name:AFFECTIONATE CARE HOSPICE LLC
Entity type:Organization
Organization Name:AFFECTIONATE CARE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MISS
Authorized Official - First Name:CRESCENCIA ELAINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:VENTURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-761-6422
Mailing Address - Street 1:7455 ARROYO CROSSING PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-4088
Mailing Address - Country:US
Mailing Address - Phone:702-761-6422
Mailing Address - Fax:702-442-8611
Practice Address - Street 1:7455 ARROYO CROSSING PKWY STE 220
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-4088
Practice Address - Country:US
Practice Address - Phone:702-761-6422
Practice Address - Fax:702-442-8611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNV20201807459OtherLICENSE