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General NPI Number Information
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NPI Number | 1114725009
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Entity Type | Organization
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Legal Business Name | ALLY LEGACY SOLUTIONS, LLC
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 3740 COPPER KEG CT
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City | LAS VEGAS
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State | NV
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Zip | 89129-6886
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Country | US
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Telephone | 702-706-3334
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Fax |
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Provider Business Mailing Address
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Address Line | 10470 W. CHEYENNE AVE, SUITE 115 PMB 158
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City | LAS VEGAS
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State | NV
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Zip | 89129
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Country | US
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Telephone | 702-706-3334
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | ELIZABETH PAULUS
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Credential |
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Telephone | 702-706-3334
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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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