Healthcare Provider Details

I. General information

NPI: 1407090442
Provider Name (Legal Business Name): TARGET GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2009
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2881 BUSINESS PARK CT SUITE 226
LAS VEGAS NV
89128-9018
US

IV. Provider business mailing address

2881 BUSINESS PARK CT SUITE 226
LAS VEGAS NV
89128-9018
US

V. Phone/Fax

Practice location:
  • Phone: 702-385-1000
  • Fax: 702-452-1001
Mailing address:
  • Phone: 702-385-1000
  • Fax: 702-452-1001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number1001863380
License Number StateNV

VIII. Authorized Official

Name: MR. GINO D CATALLI
Title or Position: OWNER
Credential:
Phone: 702-385-1000