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General NPI Number Information
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NPI Number | 1093186553
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Entity Type | Organization
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Legal Business Name | 21ST CENTURY MOVES LLC
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Dates
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Enumeration Date | 10/09/2015
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Last Update Date | 06/11/2016
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Provider Practice Location Address
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Address Line | 245 E CENTENNIAL PKWY # 23-3116
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89084-1354
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Country | US
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Telephone | 949-445-3307
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Fax |
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Provider Business Mailing Address
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Address Line | 245 E CENTENNIAL PKWY # 23-3116
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89084-1354
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Country | US
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Telephone | 949-445-3307
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Fax |
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Authorized Official
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Title or Position | FOUNDER & MANAGING MEMBER
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Name | RO BROOKS
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Credential |
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Telephone | 949-445-3307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | NV20151563054
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License Number State | NV
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