Healthcare Provider Details

I. General information

NPI: 1720916018
Provider Name (Legal Business Name): PURE PCA LAS VEGAS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3161 E WARM SPRINGS RD STE 400
LAS VEGAS NV
89120-3144
US

IV. Provider business mailing address

3087 E WARM SPRINGS RD STE 300
LAS VEGAS NV
89120-3754
US

V. Phone/Fax

Practice location:
  • Phone: 702-268-7676
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MELISSA DEMARRIAS
Title or Position: BUSINESS DIRECTOR
Credential:
Phone: 702-587-3131