Provider Demographics
NPI:1699964130
Name:HEARTBEAT OF NEVADA HEALTH SYSTEMS
Entity type:Organization
Organization Name:HEARTBEAT OF NEVADA HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BORJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-822-1941
Mailing Address - Street 1:4220 S MARYLAND PKWY
Mailing Address - Street 2:SUITE 208A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-7533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4220 S MARYLAND PKWY
Practice Address - Street 2:SUITE 208A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7533
Practice Address - Country:US
Practice Address - Phone:702-732-9878
Practice Address - Fax:702-737-5789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4451HHA-0251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health