Organization
HOME BY JACKIE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA WYNII OW (OPERATIONS MANAGER)
(702) 769-5152
Entity
Organization
Contact information
Practice address
4483 W RENO AVE, LAS VEGAS, NV 89118-1527
(702) 912-7888
Mailing address
4483 W RENO AVE, LAS VEGAS, NV 89118-1527
(702) 912-7888
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/29/2023
Last updated
03/29/2023
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