Healthcare Provider Details

I. General information

NPI: 1023552437
Provider Name (Legal Business Name): C & N PERSONAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2016
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 SPRING MOUNTAIN RD STE 107
LAS VEGAS NV
89102-8628
US

IV. Provider business mailing address

3305 SPRING MOUNTAIN RD STE 107
LAS VEGAS NV
89102-8628
US

V. Phone/Fax

Practice location:
  • Phone: 702-487-5480
  • Fax:
Mailing address:
  • Phone: 702-487-5480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberNV20151461450
License Number StateNV

VIII. Authorized Official

Name: NAKEIA FUNCHES
Title or Position: ADMINISTRATOR
Credential:
Phone: 702-487-5480