Healthcare Provider Details

I. General information

NPI: 1992465520
Provider Name (Legal Business Name): SBP GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2021
Last Update Date: 12/22/2021
Certification Date: 12/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 725-204-8359
  • 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 Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: AUTUM KAPINKIN
Title or Position: DON
Credential:
Phone: 725-204-8359