Individual
MR. CHARLES MICHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 N RAINBOW BLVD, 212, LAS VEGAS, NV 89107-1189
(702) 293-3888
(702) 293-3664
Mailing address
800 N RAINBOW BLVD, 212, LAS VEGAS, NV 89107-1189
(702) 293-3888
(702) 293-3664
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
6048PCS-6
NV
302F00000X
Exclusive Provider Organization
6048PCS-6
NV
372500000X
Chore Provider
6048PCS-6
NV
374U00000X
Home Health Aide
6048PCS-6
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538546635
—
NV
Enumeration date
12/10/2010
Last updated
03/17/2018
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