Healthcare Provider Details

I. General information

NPI: 1447829387
Provider Name (Legal Business Name): MANILA ADULT DAYCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 11/12/2022
Certification Date: 11/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 KAREN AVE UNIT B
LAS VEGAS NV
89169-1260
US

IV. Provider business mailing address

8854 CARRADORI AVE
LAS VEGAS NV
89148-4940
US

V. Phone/Fax

Practice location:
  • Phone: 702-331-5925
  • Fax: 702-947-2287
Mailing address:
  • Phone: 702-239-9235
  • Fax: 702-947-2287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARICHU PIZAN
Title or Position: CEO
Credential:
Phone: 702-239-9235