Provider Demographics
NPI:1225415185
Name:FIDELITY HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:FIDELITY HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA JUDITA
Authorized Official - Middle Name:G
Authorized Official - Last Name:QUANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-912-4442
Mailing Address - Street 1:5250 S PECOS RD
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-1289
Mailing Address - Country:US
Mailing Address - Phone:702-912-4442
Mailing Address - Fax:702-912-4443
Practice Address - Street 1:5250 S PECOS RD
Practice Address - Street 2:SUITE 100B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-1289
Practice Address - Country:US
Practice Address - Phone:702-912-4442
Practice Address - Fax:702-912-4443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNVS8121HHA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health