Organization Name: | LIBERTY CREEK HOSPICE, LLC |
NPI Number: | 1700232402 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | NYMPHA GARCIA (CEO) |
Mailing Address: | 2310 Paseo Del Prado Ste A203 Las Vegas |
State: | NV US |
Postal Code: | 891024330 |
Phone Number: | 7029102333 |
Fax Number: | |
NPI Enumeration Date: | 05/11/2016 |
NPI Last Update Date: | 05/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | NV20161219404 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |