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
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