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General NPI Number Information
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NPI Number | 1265074868
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Entity Type | Organization
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Legal Business Name | LIFECARE INFUSION INC.
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Dates
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Enumeration Date | 10/15/2019
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 6415 S FORT APACHE RD STE 175
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City | LAS VEGAS
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State | NV
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Zip | 89148-6746
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Country | US
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Telephone | 702-665-5730
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Fax | 702-780-4887
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Provider Business Mailing Address
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Address Line | 6415 S FORT APACHE RD STE 175
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City | LAS VEGAS
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State | NV
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Zip | 89148-6746
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Country | US
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Telephone | 702-330-0273
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Fax | 702-780-4887
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Authorized Official
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Title or Position | PRESIDENT/CEO/OWNER
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Name | CLETUS AMADI
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Credential |
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Telephone | 702-303-6790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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