Healthcare Provider Details

I. General information

NPI: 1780205716
Provider Name (Legal Business Name): PBP GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2020
Last Update Date: 01/10/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8930 W SUNSET RD STE 340
LAS VEGAS NV
89148-5042
US

IV. Provider business mailing address

8930 W SUNSET RD STE 340
LAS VEGAS NV
89148-5042
US

V. Phone/Fax

Practice location:
  • Phone: 725-251-5928
  • Fax: 725-251-5195
Mailing address:
  • Phone: 725-251-5928
  • Fax: 725-251-5195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ALLEN PALANT
Title or Position: DIRECTOR
Credential: RN
Phone: 725-251-5928