Healthcare Provider Details

I. General information

NPI: 1558736181
Provider Name (Legal Business Name): ALAGACARE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2015
Last Update Date: 01/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 W CHARLESTON BLVD STE O
LAS VEGAS NV
89102-1633
US

IV. Provider business mailing address

3920 W CHARLESTON BLVD STE O
LAS VEGAS NV
89102-1633
US

V. Phone/Fax

Practice location:
  • Phone: 702-478-5541
  • Fax: 702-915-7664
Mailing address:
  • Phone: 702-478-5541
  • Fax: 702-915-7664

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: MR. OLUSOGA O ALAGA
Title or Position: ADMINSTRATOR
Credential: M.D
Phone: 702-218-4370