Healthcare Provider Details

I. General information

NPI: 1184183857
Provider Name (Legal Business Name): LAS VEGAS PERSONAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2019
Last Update Date: 03/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 ARVILLE ST STE 40
LAS VEGAS NV
89103-3811
US

IV. Provider business mailing address

4350 ARVILLE ST STE 40
LAS VEGAS NV
89103-3811
US

V. Phone/Fax

Practice location:
  • Phone: 702-202-3184
  • Fax:
Mailing address:
  • Phone: 702-202-3184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: YANISEL BENITEZ
Title or Position: MANAGER
Credential:
Phone: 702-972-2246