Healthcare Provider Details
I. General information
NPI: 1316606627
Provider Name (Legal Business Name): ALEXUS AVILES
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/14/2021
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9089 S PECOS RD STE 3600
HENDERSON NV
89074-7186
US
IV. Provider business mailing address
9089 S PECOS RD STE 3600
HENDERSON NV
89074-7186
US
V. Phone/Fax
- Phone: 702-680-1526
- Fax:
- Phone: 702-680-1526
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: