Healthcare Provider Details

I. General information

NPI: 1023277357
Provider Name (Legal Business Name): MOTHER'S LOVE & CARE CENTER 2 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 06/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4130 GARLAN LN
RENO NV
89509-5438
US

IV. Provider business mailing address

4130 GARLAN LN
RENO NV
89509-5438
US

V. Phone/Fax

Practice location:
  • Phone: 775-828-5470
  • Fax: 775-828-9816
Mailing address:
  • Phone: 775-828-5470
  • Fax: 775-828-9816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number308AGC-13
License Number StateNV

VIII. Authorized Official

Name: MRS. IMELDA GUINA MILLARE
Title or Position: OWNER
Credential: ADMINISTRATOR
Phone: 775-828-5470