Healthcare Provider Details

I. General information

NPI: 1194227074
Provider Name (Legal Business Name): ARLENE MACHUCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2018
Last Update Date: 03/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 E TROPICANA AVE STE 305
LAS VEGAS NV
89119-6519
US

IV. Provider business mailing address

1515 E TROPICANA AVE STE 305
LAS VEGAS NV
89119-6519
US

V. Phone/Fax

Practice location:
  • Phone: 702-259-0231
  • Fax:
Mailing address:
  • Phone: 702-259-0231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: