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General NPI Number Information
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NPI Number | 1225605553
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Entity Type | Organization
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Legal Business Name | MV ENTERPRISE LLC
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Dates
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Enumeration Date | 06/07/2021
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Last Update Date | 04/15/2022
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Provider Practice Location Address
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Address Line | 1566 MOUNT HOOD ST
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City | LAS VEGAS
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State | NV
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Zip | 89110-1923
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Country | US
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Telephone | 702-354-5121
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Fax |
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Provider Business Mailing Address
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Address Line | 1566 MOUNT HOOD ST
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City | LAS VEGAS
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State | NV
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Zip | 89110-1923
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MYRNA DIMZON
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Credential |
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Telephone | 702-324-3647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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