# BEDROCK AT HOME NEVADA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bedrock At Home Nevada LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336907583
- **Authorized official:** CRYSTAL INDEFENZO (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (818) 281-3084

## Contact information

- **Practice address:** 1700 W HORIZON RIDGE PKWY STE 204, HENDERSON, NV 89012-4840
- **Practice address phone:** (702) 779-0147
- **Mailing address:** 1700 W HORIZON RIDGE PKWY STE 204, HENDERSON, NV 89012-4840
- **Mailing address phone:** (702) 779-0147

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 03/12/2024
- **Last updated:** 03/12/2024