Healthcare Provider Details

I. General information

NPI: 1275026965
Provider Name (Legal Business Name): HELPING HANDS CARE HOME II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2018
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11745 STONEWALL SPRINGS AVE
LAS VEGAS NV
89138-1577
US

IV. Provider business mailing address

11745 STONEWALL SPRINGS AVE
LAS VEGAS NV
89138-1577
US

V. Phone/Fax

Practice location:
  • Phone: 702-445-0088
  • Fax: 702-476-8933
Mailing address:
  • Phone: 702-445-0088
  • Fax: 702-476-8933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: LOURDES MANGUINO
Title or Position: OWNER
Credential:
Phone: 702-445-0088