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General NPI Number Information
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NPI Number | 1063883841
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Entity Type | Organization
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Legal Business Name | COMPANION CARE SUPPORT SERVICES
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 02/23/2016
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Provider Practice Location Address
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Address Line | 2620 REGATTA DR STE 102
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City | LAS VEGAS
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State | NV
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Zip | 89128-6892
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Country | US
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Telephone | 702-553-2371
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Fax | 702-546-1321
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Provider Business Mailing Address
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Address Line | 2620 REGATTA DR STE 102
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City | LAS VEGAS
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State | NV
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Zip | 89128-6892
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Country | US
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Telephone | 702-553-2371
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Fax | 702-546-1321
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SABRINA DILLINGHAM
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Credential |
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Telephone | 702-553-2371
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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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