Healthcare Provider Details

I. General information

NPI: 1922404938
Provider Name (Legal Business Name): ADULT CARE CONNECTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2014
Last Update Date: 11/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9712 ENNISKEEN AVE
LAS VEGAS NV
89129-8001
US

IV. Provider business mailing address

PO BOX 61212
LAS VEGAS NV
89160-1212
US

V. Phone/Fax

Practice location:
  • Phone: 702-360-0415
  • Fax: 702-360-7396
Mailing address:
  • Phone: 702-731-5941
  • Fax: 702-731-5971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number53AGC-25
License Number StateNV

VIII. Authorized Official

Name: PATRICIA THERESA BRUSHFILED
Title or Position: PRESIDENT
Credential: RFA
Phone: 702-731-5941