PHENOMENAL CARE HOME HEALTH (NPI# 1619471141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619471141 |
| Entity Type | Organization |
| Organization Name | PHENOMENAL CARE HOME HEALTH |
| Practice Address |
501 S Rancho Dr Ste D19 Las Vegas NV 89106-4832 |
| Practice Telephone | 7026130474 |
| Practice Fax Number | 7025533484 |
| Mailing Telephone | 7026130474 |
| Mailing Fax Number | 7025533484 |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2018-03-20 |
| Authorized Official Name | MRS. KIMBERLY RASHONE BROUSSARD (CEO / OWNER) |
| Authorized Official Telephone | 7026130468 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| Street Address |
501 S RANCHO DR STE D19 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89106-4832 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780003319 | Delores Lynn Carr | Marriage & Family Therapist | 501 S Rancho Dr Ste D19, Las Vegas, NV 89106-4832 | 2014-04-10 |
| 1285294751 | Angel Hearts Mental Health | Case Management | 501 S Rancho Dr Ste D19, Las Vegas, NV 89106-4832 | 2019-06-17 |
| 1093285389 | Wright's Behavior Health | Psychologist | 501 S Rancho Dr Ste D19, Las Vegas, NV 89106-4832 | 2018-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555772 | Graciela Miranda Cocorpio | Technician | 820 Rancho Ln Suite #40, Las Vegas, NV 89106 | 2020-10-09 |
| 1679101679 | A Better You Wellness Center | Counselor | 320 W Monroe Street, Las Vegas, NV 89106 | 2020-03-27 |
| 1730725177 | Mariah La'neese Jones | Rehabilitation Practitioner | 400 Shadow Lane Ste 106, Las Vegas, NV 89106 | 2019-11-20 |
| 1417592841 | Lourdes Rita Apumayta-paredes | Technician | 820 Rancho Lane, Suite #40, Las Vegas, NV 89106 | 2019-11-08 |
| 1902456551 | Marisela Pena | Technician | 820 Rancho Ln., 25, Las Vegas, NV 89106 | 2019-09-16 |
| 1992368724 | Amber Nicole Mahajan | Nurse Practitioner | 2020 Wellness Way, Suite 300, Las Vegas, NV 89106 | 2019-04-17 |
| 1568924215 | Arlandrea Tarvins | Behavioral Analyst | 1048 Miller Ave, Las Vegas, NV 89106 | 2019-04-02 |
| 1427510361 | Erik Pennell | Student in an Organized Health Care Education/Training Program | 1542 Pinto Ln, 2nd Floor, Las Vegas, NV 89106 | 2019-04-01 |
| 1245702729 | Bruce Mark Babb | Technician | 820 Rancho Lane Ste #40, Las Vegas, NV 89106 | 2018-12-21 |
| 1639649213 | Antonio Ruiz Pelfort | Technician | 1951 Stella Lake St Suite 36, Las Vegas, NV 89106 | 2018-11-27 |
| Find all providers in zip 89106 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457542 | Maria Isabel Bedolla | Home Health | 5402 S Sir Richard Dr, Las Vegas, NV 89110-4863 | 2020-11-05 |
| 1083212013 | Talya Fritz | Home Health | 10220 Delray Beach Ave Unit 203, Las Vegas, NV 89129-1058 | 2020-10-12 |
| 1174121305 | Pena Francia Home Health Care LLC | Home Health | 2235 E Flamingo Rd Ste 220, Las Vegas, NV 89119-0807 | 2020-10-10 |
| 1467050773 | Real Community Home Health LLC | Home Health | 4660 S Eastern Ave Ste 205, Las Vegas, NV 89119-6139 | 2020-10-09 |
| 1114524311 | Creek View Home Health LLC | Home Health | 2950 E Flamingo Rd Ste H, Las Vegas, NV 89121-5208 | 2020-10-01 |
| 1164038196 | Tammy E Smith | Home Health | 1500 Karen Ave, 65, Las Vegas, NV 89169 | 2020-09-16 |
| 1326653908 | Annjo's Home Health Care Inc | Home Health | 3430 E Flamingo Rd Ste 107a, Las Vegas, NV 89121-5003 | 2020-09-10 |
| 1164036968 | My Family Home Health LLC | Home Health | 830 E Sahara Ave, Las Vegas, NV 89104-3009 | 2020-08-31 |
| 1023620333 | 1st Choice Care LLC | Home Health | 6865 Sigri St, Las Vegas, NV 89166-7016 | 2020-08-18 |
| 1114544566 | Gamaliel Digan | Home Health | 3100 E Charleston Blvd Ste 113, Las Vegas, NV 89104-6666 | 2020-07-01 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.