Basic Information
Provider Information
NPI: 1366924136
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BECKER
FirstName: RITA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 604 CALCUTTA LN
Address2:  
City: HENDERSON
State: NV
PostalCode: 890157402
CountryCode: US
TelephoneNumber: 7025651370
FaxNumber:  
Practice Location
Address1: 160 E HORIZON DR
Address2:  
City: HENDERSON
State: NV
PostalCode: 890157933
CountryCode: US
TelephoneNumber: 7026443600
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/29/2018
LastUpdateDate: 08/29/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
372500000X NVN Nursing Service Related ProvidersChore Provider 
372600000X NVN Nursing Service Related ProvidersAdult Companion 
376J00000X NVN Nursing Service Related ProvidersHomemaker 
3747P1801X NVY Nursing Service Related ProvidersTechnicianPersonal Care Attendant
3747A0650X NVN Nursing Service Related ProvidersTechnicianAttendant Care Provider

No ID Information.


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