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NPI Code Detail

MEDICARE: DD PERSONAL CARE LLC

MEDICARE: DD PERSONAL CARE LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency7755PCS-0NV

General Provider Information

NPI Number : 1407276397
Entity Type Code : Organization
Provider Name (Legal Business Name) : DD PERSONAL CARE LLC
Provider Business Mailing Address
First Line : PO BOX 43753
Second Line :
City : LAS VEGAS
State : NV
Zip : 89116-1753
Country : US
Telephone Number : 702-207-0842
Fax Number : 702-207-0357
Provider Business Practice Location Address
First Line : 2150 S EASTERN AVE STE A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-4109
Country : US
Telephone Number : 702-207-0842
Fax Number : 702-207-0357
Authorized Official
Title or Position : OWNER/ADMINISTRATOR
Name : MRS. ADISNUBIA VEGA-RODRIGUEZ
Credential :
Telephone Number : 702-207-0842
Provider Enumeration Date : 04/18/2014
Last Update Date : 12/30/2024

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Directions to “DD PERSONAL CARE LLC ” Practice Location

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