Provider Demographics
NPI:1861935991
Name:LOVING HANDS OF NEVADA HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:LOVING HANDS OF NEVADA HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:CORA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:TRACY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-566-2433
Mailing Address - Street 1:153 W LAKE MEAD PKWY
Mailing Address - Street 2:2240
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-7044
Mailing Address - Country:US
Mailing Address - Phone:702-566-2433
Mailing Address - Fax:
Practice Address - Street 1:153 W LAKE MEAD PKWY
Practice Address - Street 2:2240
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015
Practice Address - Country:US
Practice Address - Phone:702-566-2433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOVING HANDS OF NEVADA HOME HEALTH CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-21
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X
NVNV20161058473251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1861935991Medicaid