Healthcare Provider Details
I. General information
NPI: 1760965685
Provider Name (Legal Business Name): IRANIA GARCES
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/07/2018
Last Update Date: 09/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4550 W OAKEY BLVD STE 101
LAS VEGAS NV
89102-1506
US
IV. Provider business mailing address
9045 MODERN CT
LAS VEGAS NV
89149-3085
US
V. Phone/Fax
- Phone: 702-906-1999
- Fax: 702-906-1998
- Phone: 702-277-3317
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: