Provider Demographics
NPI:1275420580
Name:AUTUMN LIGHT HOSPICE CARE LLC
Entity type:Organization
Organization Name:AUTUMN LIGHT HOSPICE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CACANINDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-801-6458
Mailing Address - Street 1:8290 W SAHARA AVE STE 152
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8932
Mailing Address - Country:US
Mailing Address - Phone:323-801-6458
Mailing Address - Fax:
Practice Address - Street 1:8290 W SAHARA AVE STE 152
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-8932
Practice Address - Country:US
Practice Address - Phone:323-801-6458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based