Provider Demographics
NPI:1588272769
Name:GENERATIONS HOME CARE LLC
Entity type:Organization
Organization Name:GENERATIONS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-970-1449
Mailing Address - Street 1:5256 FIGHTING FISH WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-0621
Mailing Address - Country:US
Mailing Address - Phone:702-970-1449
Mailing Address - Fax:702-368-0318
Practice Address - Street 1:5256 FIGHTING FISH WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-0621
Practice Address - Country:US
Practice Address - Phone:702-970-1449
Practice Address - Fax:702-970-1449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV10060-PCS-0OtherDEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF PUBLIC AND BEHAVORIAL HEALTH