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General NPI Number Information
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NPI Number | 1154492320
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Entity Type | Organization
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Legal Business Name | PTV1, INC.
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 04/02/2021
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Provider Practice Location Address
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Address Line | 70 E HORIZON RIDGE PKWY STE 100
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City | HENDERSON
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State | NV
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Zip | 89002-7936
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Country | US
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Telephone | 702-644-3600
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Fax | 702-719-5665
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Provider Business Mailing Address
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Address Line | 70 E HORIZON RIDGE PKWY STE 100
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City | HENDERSON
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State | NV
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Zip | 89002-7936
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Country | US
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Telephone | 702-644-3600
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Fax | 702-719-5665
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Authorized Official
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Title or Position | OWNER
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Name | EDGAR JIMENEZ
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Credential |
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Telephone | 702-273-6658
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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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