Provider Demographics
NPI:1053725549
Name:SUPERIOR HOSPICE OF LAS VEGAS, LLC
Entity type:Organization
Organization Name:SUPERIOR HOSPICE OF LAS VEGAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-843-2526
Mailing Address - Street 1:3033 W HORIZON RIDGE PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3888
Mailing Address - Country:US
Mailing Address - Phone:702-843-2526
Mailing Address - Fax:702-897-0918
Practice Address - Street 1:8000 VANTAGE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4781
Practice Address - Country:US
Practice Address - Phone:210-507-8740
Practice Address - Fax:210-558-7723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based