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NPI Code Detail

MEDICARE: ELIZABETH ACOSTA

MEDICARE: ELIZABETH ACOSTA
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
13747P1801XPersonal Care Attendant
2106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639738289
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ACOSTA
Provider Business Mailing Address
First Line : 5604 HARMONY AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-2625
Country : US
Telephone Number : 702-910-0300
Fax Number :
Provider Business Practice Location Address
First Line : 5604 HARMONY AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-2625
Country : US
Telephone Number : 702-910-0300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2019
Last Update Date : 11/06/2020

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Directions to “ ELIZABETH ACOSTA ” Practice Location

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