- Enrollment id
- O20160318000214
- Enrollment state
- NV
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1164817342
- Multiple npi flag
- N
- Ccn
- 297221
- Associate id
- 2264739283
- Organization name
- NEVADA PREFERRED HOME HEALTH CARE LLC
- Incorporation date
- 2015-01-14
- Incorporation state
- NV
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 5600 SPRING MOUNTAIN RD
- Address line 2
- STE 203
- City
- LAS VEGAS
- State
- NV
- Zip code
- 891468823