# AGAVE SPECIALTY CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Agave Specialty Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649086372
- **Authorized official:** HOMER SIMS (OWNER)
- **Authorized official phone:** (702) 350-6300

## Contact information

- **Practice address:** 3335 RAWHIDE ST, LAS VEGAS, NV 89120-1933
- **Practice address phone:** (725) 204-9005
- **Practice address fax:** (702) 268-8925
- **Mailing address:** 2714 DUCK POND CT, HENDERSON, NV 89074-1915

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311500000X | Alzheimer Center (Dementia Center) | — | NULL | Yes |
| 311ZA0620X | Adult Care Home Facility | — | NULL | — |

## Other

- **Enumeration date:** 12/07/2024
- **Last updated:** 04/03/2025