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Organization

SPARKS HOSPICE CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOMINGO BACCAY JR. (CEO/CFO/ADMINISTRATOR)
(818) 267-7945
Entity
Organization

Contact information

Practice address
2100 S MARYLAND PKWY STE 9, LAS VEGAS, NV 89104-3225
(818) 267-7945
Mailing address
2100 S MARYLAND PKWY STE 9, LAS VEGAS, NV 89104-3225
(818) 267-7945

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary

Other

Enumeration date
06/07/2022
Last updated
09/27/2022
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