Healthcare Provider Details

I. General information

NPI: 1295960193
Provider Name (Legal Business Name): SCOLEO ENTERPRISES,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2009
Last Update Date: 05/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7550 W ALEXANDER RD
LAS VEGAS NV
89129-6501
US

IV. Provider business mailing address

7550 W ALEXANDER RD
LAS VEGAS NV
89129-6501
US

V. Phone/Fax

Practice location:
  • Phone: 702-877-0007
  • Fax: 702-877-6963
Mailing address:
  • Phone: 702-877-0007
  • Fax: 702-877-6963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1005762333
License Number StateNV

VIII. Authorized Official

Name: MR. ZAREH TANAHAN
Title or Position: PRESIDENT
Credential:
Phone: 702-877-0007