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General NPI Number Information
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NPI Number | 1043939861
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Entity Type | Organization
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Legal Business Name | PERSONAL CARE NEVADA LLC
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Dates
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Enumeration Date | 08/24/2022
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 6245 HARRISON DR STE 6
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City | LAS VEGAS
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State | NV
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Zip | 89120-4035
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Country | US
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Telephone | 725-300-0104
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Fax | 725-300-0446
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Provider Business Mailing Address
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Address Line | 6245 HARRISON DR STE 6
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City | LAS VEGAS
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State | NV
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Zip | 89120-4035
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Country | US
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Telephone | 725-300-0104
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Fax | 725-300-0446
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Authorized Official
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Title or Position | OWNER
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Name | JESSICA DAVIS
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Credential |
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Telephone | 725-300-0104
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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 |
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License Number State |
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