Organization
SKYSHROUD HOME HEALTH CORP
Active
Organization
SKYSHROUD HOME HEALTH CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAINT DON NIEL BAUTISTA REYES PT, ATP (CEO)
(702) 289-9797
Entity
Organization
Contact information
Practice address
5480 COLD LAKE ST, LAS VEGAS, NV 89148-7609
(702) 289-9797
Mailing address
5480 COLD LAKE ST, LAS VEGAS, NV 89148-7609
(702) 289-9797
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225200000X
Physical Therapy Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447850318
—
NV
05
—
1457804239
—
NV
05
—
1750957148
—
NV
Enumeration date
04/25/2024
Last updated
04/25/2024
Update your record
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