Provider Demographics
NPI:1588115844
Name:EMERALD HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:EMERALD HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:GABAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-498-3854
Mailing Address - Street 1:3401 SIRIUS AVE
Mailing Address - Street 2:UNIT #1
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-7724
Mailing Address - Country:US
Mailing Address - Phone:702-483-5155
Mailing Address - Fax:702-483-3150
Practice Address - Street 1:3401 SIRIUS AVE
Practice Address - Street 2:UNIT #1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-7724
Practice Address - Country:US
Practice Address - Phone:702-483-5155
Practice Address - Fax:702-483-3150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8580-HHA-0251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health