ST JUDE HOME CARE, INC (NPI# 1043782204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043782204 |
| Entity Type | Organization |
| Organization Name | ST JUDE HOME CARE, INC |
| Practice Address |
6880 Hathaway Dr Las Vegas NV 89156-7143 |
| Practice Telephone | 7024098957 |
| Practice Fax Number | 7024371473 |
| Mailing Telephone | 7024098957 |
| Mailing Fax Number | 7024371473 |
| Enumeration Date | 2018-12-27 |
| Last Update Date | 2018-12-27 |
| Authorized Official Name | JESSE ABRIL (PRESIDENT) |
| Authorized Official Telephone | 7024098957 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| Street Address |
6880 HATHAWAY DR |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89156-7143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811478712 | Malaika Tamu Hadley Jaffe | Community Based Residential Treatment Facility, Mental Illness | 6644 Jordan River Dr, Las Vegas, NV 89156 | 2018-08-28 |
| 1760908719 | Together We Stand Behavioral Health | Behavioral Analyst | 2110 N Los Feliz St #2072, Las Vegas, NV 89156 | 2017-08-21 |
| 1720356736 | Lucia Carol Matthew | Counselor | 730 N Eastern Avenue, Suite 110, Family Guidance and Wellness Network, Las Vegas, NV 89156 | 2011-12-05 |
| 1033410261 | Henry Sylvester Ebron IIi | Rehabilitation Practitioner | 2110 Los Feliz St, 2083, Las Vegas, NV 89156 | 2010-11-04 |
| 1801196878 | Regina Jackson | Rehabilitation Practitioner | 5254 Paradise Skies Avenue, Las Vegas, NV 89156 | 2010-10-25 |
| 1780830828 | Chris Elaine L Mariano | Registered Nurse | 1972 Napoleon Dr, Las Vegas, NV 89156 | 2008-08-08 |
| 1114320983 | A Omega Dental, LLC | Dentist | 6775 E Lake Mead Blvd, Ste # B9 & B10, Las Vegas, NV 89156 | 2014-10-07 |
| 1437404233 | Christina Maynard | Rehabilitation Practitioner | 2065 Scanlon Ferry Ct Unit 103, Las Vegas, NV 89156-0122 | 2012-07-17 |
| 1851769236 | Michael Spiegelhauer | Behavioral Analyst | 6168 Bluehill Ave Unit 2, Las Vegas, NV 89156-0204 | 2015-09-02 |
| 1760036032 | Mario Henderson | Technician | 5450 E. Lake Mead Blvd, Building D Apt. 225, Las Vegas, NV 89156-0908 | 2019-07-25 |
| Find all providers in zip 89156 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1902444557 | Adult Care Home LLC | Custodial Care Facility | 10315 Queensbury Ave, Las Vegas, NV 89135-2132 | 2019-12-13 |
| 1821634882 | Golden Sunshine Alzheimers Care | Custodial Care Facility | 309 La Rue Ct, Las Vegas, NV 89145-4170 | 2019-11-25 |
| 1497391635 | Sunlight Garden Group LLC | Custodial Care Facility | 950 Garden Breeze Way, Las Vegas, NV 89123-3630 | 2019-11-22 |
| 1922644459 | Golden Years Residential Care Facility, LLC | Custodial Care Facility | 8920 Loggers Mill Ave, Las Vegas, NV 89143-5423 | 2019-11-19 |
| 1326682667 | Golden Sunshine Alzheimer's Home Care, Inc. | Custodial Care Facility | 7765 Clearwood Ave, Las Vegas, NV 89123-0301 | 2019-10-30 |
| 1902457021 | At Nightingales LLC | Custodial Care Facility | 813 Fairway Dr, Las Vegas, NV 89107-2012 | 2019-09-20 |
| 1104485481 | Silverado Ranch Memory Care, Inc. | Custodial Care Facility | 248 Barletta Ave, Las Vegas, NV 89123-7410 | 2019-06-10 |
| 1912565482 | Synergy Usa, LLC | Custodial Care Facility | 8204 Cabin Springs Ave, Las Vegas, NV 89131-4622 | 2019-05-30 |
| 1467913335 | Advanced Care for The Elderly, LLC | Custodial Care Facility | 9501 Mulroona Ct, Las Vegas, NV 89129-6921 | 2019-03-25 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.