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General NPI Number Information
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NPI Number | 1013528397
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Entity Type | Organization
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Legal Business Name | DURANGO PERSONAL CARE LLC
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Dates
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Enumeration Date | 08/11/2020
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Last Update Date | 12/08/2020
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Provider Practice Location Address
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Address Line | 7251 W LAKE MEAD BLVD SUITE 300 - 374
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City | LAS VEGAS
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State | NV
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Zip | 89128-8351
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Country | US
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Telephone | 702-514-0340
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Fax |
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Provider Business Mailing Address
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Address Line | 8431 W FISHER AVE
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City | LAS VEGAS
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State | NV
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Zip | 89149-4059
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Country | US
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Telephone | 702-983-0294
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT BAKALOR
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Credential | LPN
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Telephone | 702-245-8610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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