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General NPI Number Information
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NPI Number | 1053827212
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Entity Type | Organization
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Legal Business Name | A PRECIOUS GEMS LLC
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Dates
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Enumeration Date | 12/22/2017
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Last Update Date | 12/22/2017
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Provider Practice Location Address
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Address Line | 1733 HUNTERS BLUFF DR
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032-7983
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Country | US
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Telephone | 702-636-5501
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Fax |
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Provider Business Mailing Address
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Address Line | 695 LYNMAR CT
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City | HENDERSON
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State | NV
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Zip | 89052-8751
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Country | US
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Telephone | 702-218-3319
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Fax |
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Authorized Official
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Title or Position | FACILITY MANAGER/OWNER
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Name | RAYMOND AQUINO TORIO
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Credential |
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Telephone | 702-218-3319
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 3171-AGC-20
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License Number State | NV
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