MEDICARE: SOCIALCURE CENTER 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
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1962276980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOCIALCURE CENTER LLC

Provider Business Mailing Address
First Line	:	4055 SPENCER ST STE 208
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5251
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4055 SPENCER ST STE 208
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5251
Country	:	US
Telephone Number	:	702-809-4555
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHAYNE TUMBAGA MORALES
Credential	:
Telephone Number	:	702-809-4555

Provider Enumeration Date	:	11/09/2023
Last Update Date	:	11/09/2023

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Directions to “SOCIALCURE CENTER LLC ” Practice Location

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