Healthcare Provider Details

I. General information

NPI: 1629388426
Provider Name (Legal Business Name): VEGAS ADULT DAY HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2010
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3417 S JONES BLVD
LAS VEGAS NV
89146-6784
US

IV. Provider business mailing address

3417 S. JONES BLVD
LAS VEGAS NV
89146
US

V. Phone/Fax

Practice location:
  • Phone: 702-768-7285
  • Fax: 702-382-9359
Mailing address:
  • Phone: 702-768-7285
  • Fax: 702-382-9359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number5306ADC-0
License Number StateNV

VIII. Authorized Official

Name: CHENG WU
Title or Position: CO-OWNER/MANAGER
Credential:
Phone: 702-768-7285