MEDICARE: ALUXE RESIDENCE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	3104A0625X	Assisted Living Facility (Mental Illness)
2	3104A0630X	Assisted Living Facility (Behavioral Disturbances)
3	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1205681582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALUXE RESIDENCE LLC

Provider Business Mailing Address
First Line	:	3059 EL CAMINO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6619
Country	:	US
Telephone Number	:	702-818-0346
Fax Number	:

Provider Business Practice Location Address
First Line	:	3059 EL CAMINO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6619
Country	:	US
Telephone Number	:	702-818-0346
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JUAN CARLOS PORCIUNCULA COMAHIG
Credential	:
Telephone Number	:	702-818-0346

Provider Enumeration Date	:	04/20/2024
Last Update Date	:	04/20/2024

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Directions to “ALUXE RESIDENCE LLC ” Practice Location

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