Healthcare Provider Details

I. General information

NPI: 1154192581
Provider Name (Legal Business Name): EZER PERSONAL CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 01/15/2024
Certification Date: 01/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 E CHARLESTON BLVD STE 160
LAS VEGAS NV
89104-1542
US

IV. Provider business mailing address

720 E CHARLESTON BLVD STE 160
LAS VEGAS NV
89104-1542
US

V. Phone/Fax

Practice location:
  • Phone: 702-695-0117
  • Fax:
Mailing address:
  • Phone: 702-695-0117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: NICOLAS LEE
Title or Position: ADMINISTRATOR
Credential:
Phone: 702-695-0117