Organization
HEALTH TO NEVADA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER MICHAEL BANNISTER (OWNER/CEO)
(775) 772-7551
Entity
Organization
Contact information
Practice address
4346 CRIMSON TIDE AVE, N LAS VEGAS, NV 89031-0446
(702) 405-8392
(702) 489-3013
Mailing address
4346 CRIMSON TIDE AVE, N LAS VEGAS, NV 89031-0446
(702) 405-8392
(702) 489-3013
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
8302PCS-0
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568850204
NPI - PROVIDER TYPE 30
NV
01
—
1619336864
NPI - PROVIDER TYPE 58
NV
Enumeration date
05/11/2016
Last updated
05/11/2016
About Stedi
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