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General NPI Number Information
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NPI Number | 1013460278
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Entity Type | Organization
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Legal Business Name | SYB, LLC.
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Dates
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Enumeration Date | 07/24/2016
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Last Update Date | 07/24/2016
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Provider Practice Location Address
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Address Line | 1180 N TOWN CENTER DR SUITE #100
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City | LAS VEGAS
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State | NV
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Zip | 89144-6363
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Country | US
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Telephone | 702-800-4616
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Fax |
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Provider Business Mailing Address
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Address Line | 3058 EMERALD WIND ST
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City | HENDERSON
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State | NV
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Zip | 89052-3098
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Country | US
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Telephone | 702-237-1611
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROBERT EDWARD SWADKINS
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Credential |
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Telephone | 702-237-1611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 8587-PCS-0
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License Number State | NV
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