Healthcare Provider Details

I. General information

NPI: 1851870737
Provider Name (Legal Business Name): DREAM ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2018
Last Update Date: 08/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 W ALEXANDER RD STE 103
N LAS VEGAS NV
89032-9095
US

IV. Provider business mailing address

1445 W ALEXANDER RD STE 103
N LAS VEGAS NV
89032-9095
US

V. Phone/Fax

Practice location:
  • Phone: 702-292-3434
  • Fax:
Mailing address:
  • Phone: 702-292-3434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number9012-ADC-0
License Number StateNV

VIII. Authorized Official

Name: MR. ALAN B JAUREGUI
Title or Position: ADMINISTRATOR
Credential:
Phone: 702-266-7277