Healthcare Provider Details

I. General information

NPI: 1225689300
Provider Name (Legal Business Name): GOLDEN DRAGON ADULT DAY HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2019
Last Update Date: 09/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6120 W TROPICANA AVE STE A12
LAS VEGAS NV
89103-4600
US

IV. Provider business mailing address

6120 W TROPICANA AVE STE A12
LAS VEGAS NV
89103-4600
US

V. Phone/Fax

Practice location:
  • Phone: 702-266-7277
  • Fax:
Mailing address:
  • Phone: 702-266-7277
  • Fax:

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: MR. ALAN B JAUREGUI
Title or Position: ADMINISTRATOR
Credential: APRN
Phone: 702-266-7277