Provider Demographics
NPI:1164033585
Name:DEVONEE'S HEART & SOUL HEALTHCARE LLC
Entity type:Organization
Organization Name:DEVONEE'S HEART & SOUL HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHALONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-690-6984
Mailing Address - Street 1:5000 W OAKEY BLVD STE A3-4
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-0391
Mailing Address - Country:US
Mailing Address - Phone:702-690-6984
Mailing Address - Fax:
Practice Address - Street 1:5000 W OAKEY BLVD STE A3-4
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-0391
Practice Address - Country:US
Practice Address - Phone:702-690-6984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care