Healthcare Provider Details

I. General information

NPI: 1134001530
Provider Name (Legal Business Name): C & N PERSONAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 SPRING MOUNTAIN RD STE 107
LAS VEGAS NV
89102-8628
US

IV. Provider business mailing address

3305 SPRING MOUNTAIN RD STE 107
LAS VEGAS NV
89102-8628
US

V. Phone/Fax

Practice location:
  • Phone: 702-487-5480
  • Fax: 702-487-5535
Mailing address:
  • Phone: 702-487-5480
  • Fax: 702-487-5535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TALAYA GREEN
Title or Position: ADMINISTRATOR
Credential:
Phone: 702-487-5480