Organization
PHENOMENAL CARE HOME HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY RASHONE BROUSSARD (CEO / OWNER)
(702) 613-0468
Entity
Organization
Contact information
Practice address
501 S RANCHO DR STE D19, LAS VEGAS, NV 89106-4832
(702) 613-0474
(702) 553-3484
Mailing address
501 S RANCHO DR STE D19, LAS VEGAS, NV 89106-4832
(702) 613-0474
(702) 553-3484
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/20/2018
Last updated
03/20/2018
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