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General NPI Number Information
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NPI Number | 1497186811
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Entity Type | Organization
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Legal Business Name | ADVANCED CARE GROUP LLC
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Dates
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Enumeration Date | 12/11/2013
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Last Update Date | 02/16/2021
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Provider Practice Location Address
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Address Line | 6293 DEAN MARTIN DR STE D-G
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City | LAS VEGAS
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State | NV
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Zip | 89118-3845
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Country | US
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Telephone | 281-235-3417
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Fax |
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Provider Business Mailing Address
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Address Line | 6293 DEAN MARTIN DR
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City | LAS VEGAS
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State | NV
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Zip | 89118-3845
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Country | US
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Telephone | 702-216-0377
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Fax | 702-216-0339
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MOSES IRUBOR
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Credential |
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Telephone | 702-216-0377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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