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General NPI Number Information
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NPI Number | 1407276397
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Entity Type | Organization
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Legal Business Name | DD PERSONAL CARE LLC
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Dates
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Enumeration Date | 04/18/2014
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 2150 S EASTERN AVE STE A
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City | LAS VEGAS
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State | NV
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Zip | 89104-4109
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Country | US
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Telephone | 702-207-0842
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Fax | 702-207-0357
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Provider Business Mailing Address
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Address Line | PO BOX 43753
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City | LAS VEGAS
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State | NV
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Zip | 89116-1753
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Country | US
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Telephone | 702-207-0842
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Fax | 702-207-0357
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MRS. ADISNUBIA VEGA-RODRIGUEZ
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Credential |
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Telephone | 702-207-0842
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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 | 7755PCS-0
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License Number State | NV
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