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General NPI Number Information
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NPI Number | 1346729118
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Entity Type | Organization
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Legal Business Name | SAFE AT HOME
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Dates
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Enumeration Date | 08/12/2018
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 4055 SPENCER ST STE 109
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City | LAS VEGAS
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State | NV
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Zip | 89119-5250
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Country | US
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Telephone | 702-405-9565
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Fax | 702-258-1667
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Provider Business Mailing Address
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Address Line | 4055 SPENCER ST STE 109
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City | LAS VEGAS
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State | NV
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Zip | 89119-5250
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Country | US
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Telephone | 702-405-9565
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Fax | 702-258-1667
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Authorized Official
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Title or Position | OWNER
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Name | MS. ERIKA VERGARA
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Credential |
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Telephone | 702-405-9565
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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 | 9257-PCS-0
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License Number State | NV
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