Healthcare Provider Details

I. General information

NPI: 1316357882
Provider Name (Legal Business Name): V.N. SENIOR CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

993 GOLD BEAR DR
HENDERSON NV
89052-3846
US

IV. Provider business mailing address

3281 WINERY RD
PAHRUMP NV
89048-4845
US

V. Phone/Fax

Practice location:
  • Phone: 702-358-5232
  • Fax: 702-548-4152
Mailing address:
  • Phone: 775-727-1261
  • Fax: 702-548-4152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number5679AGZ-7
License Number StateNV

VIII. Authorized Official

Name: CHRISTOPHER MIRANDO
Title or Position: ADMINISTRATOR/MANAGER
Credential:
Phone: 702-358-5232