Healthcare Provider Details

I. General information

NPI: 1851752265
Provider Name (Legal Business Name): M&M ANGEL ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2016
Last Update Date: 03/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6895 W CHARLESTON BLVD
LAS VEGAS NV
89117-1640
US

IV. Provider business mailing address

6895 W CHARLESTON BLVD
LAS VEGAS NV
89117-1640
US

V. Phone/Fax

Practice location:
  • Phone: 702-281-7062
  • Fax:
Mailing address:
  • Phone: 702-281-7062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. LARHONYA M RICHARDS
Title or Position: DIRECTOR
Credential: LICENSED CPC MFT-I
Phone: 702-281-7062