Healthcare Provider Details

I. General information

NPI: 1780150300
Provider Name (Legal Business Name): ELEOS CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 04/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N GRN VLY PKWY # 440-457
HENDERSON NV
89074-6170
US

IV. Provider business mailing address

1000 N GRN VLY PKWY # 440-457
HENDERSON NV
89074-6170
US

V. Phone/Fax

Practice location:
  • Phone: 702-687-1350
  • Fax:
Mailing address:
  • Phone: 702-687-1350
  • Fax: 702-920-7943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: GUERIN BONPANE SENTER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 702-687-1350