Organization
A SACRED HOME HEALTH CARE LLC
Active
Other names
Advance Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH GAMBOA CAZARES (ADMINISTRATOR)
(702) 834-6560
Entity
Organization
Contact information
Practice address
7040 LAREDO ST STE E, LAS VEGAS, NV 89117
(702) 834-6560
(702) 834-8494
Mailing address
7040 LAREDO ST STE E, LAS VEGAS, NV 89117-3044
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
NV20151325001
NV
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
374U00000X
Home Health Aide
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366821316
—
NV
Enumeration date
05/23/2015
Last updated
06/26/2019
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