Provider Demographics
NPI:1588444376
Name:NEVADA VALLEY HOME CARE
Entity type:Organization
Organization Name:NEVADA VALLEY HOME CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-505-3841
Mailing Address - Street 1:4387 FLOWERDALE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-4207
Mailing Address - Country:US
Mailing Address - Phone:702-405-7695
Mailing Address - Fax:
Practice Address - Street 1:6791 ELMDALE PL
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-4213
Practice Address - Country:US
Practice Address - Phone:702-505-3841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home