Healthcare Provider Details

I. General information

NPI: 1750775649
Provider Name (Legal Business Name): INTERNATIONAL ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2015
Last Update Date: 03/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 RENAISSANCE DR SUITE A
LAS VEGAS NV
89119-6163
US

IV. Provider business mailing address

1065 E FLAMINGO RD RM 802
LAS VEGAS NV
89119-7449
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberAPN000962
License Number StateNV

VIII. Authorized Official

Name: LIGAYA BIGLANGAWA
Title or Position: MANAGING MEMBER
Credential:
Phone: 702-266-7277