Healthcare Provider Details

I. General information

NPI: 1538699830
Provider Name (Legal Business Name): GOLDEN DAYS ADULT DAYCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2017
Last Update Date: 06/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 E TROPICANA AVE STE 26-28
LAS VEGAS NV
89119-6529
US

IV. Provider business mailing address

1775 E TROPICANA AVE STE 26-28
LAS VEGAS NV
89119-6529
US

V. Phone/Fax

Practice location:
  • Phone: 702-676-1177
  • Fax: 702-798-0529
Mailing address:
  • Phone: 702-676-1177
  • Fax: 702-798-0529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number8798-ADC-0
License Number StateNV

VIII. Authorized Official

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