Organization
ISU INC
Active
Other names
Triple C PCA Agency & Triple C Home Health Agency
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHUKA E HUMPHREYS PHD (PRESIDENT)
(702) 459-7500
Entity
Organization
Contact information
Practice address
1745 N. NELLIS BLVD, STE A, LAS VEGAS, NV 89115-3673
(702) 459-7500
(702) 459-1176
Mailing address
1745 N. NELLIS BLVD, STE A, LAS VEGAS, NV 89115-3673
(702) 459-7500
(702) 459-1176
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
6033HHA-O
NV
253Z00000X
In Home Supportive Care Agency
6374PCS-0
NV
Other
Enumeration date
11/03/2011
Last updated
11/08/2011
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