Healthcare Provider Details

I. General information

NPI: 1639763667
Provider Name (Legal Business Name): LPD2 LIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2021
Last Update Date: 02/20/2021
Certification Date: 02/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 S GREEN VALLEY PKWY
HENDERSON NV
89012-3132
US

IV. Provider business mailing address

170 S GREEN VALLEY PKWY
HENDERSON NV
89012-3132
US

V. Phone/Fax

Practice location:
  • Phone: 702-827-9979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DANTE TOLBERT
Title or Position: FOUNDER
Credential:
Phone: 702-827-9979