Healthcare Provider Details
I. General information
NPI: 1740641372
Provider Name (Legal Business Name): BRINGING ABOUT INDEPENDENCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/09/2016
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3130 S DURANGO DR STE 400
LAS VEGAS NV
89117-4456
US
IV. Provider business mailing address
PO BOX 82045
LAS VEGAS NV
89180-2045
US
V. Phone/Fax
- Phone: 702-325-5928
- Fax: 702-876-9110
- Phone: 702-325-5928
- Fax: 702-876-9110
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NATHAN
D
BOYACK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 702-325-5928