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General NPI Number Information
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NPI Number | 1518105188
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Entity Type | Organization
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Legal Business Name | CARE CONNECTORS
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 4952 DANUBE AVE
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City | LAS VEGAS
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State | NV
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Zip | 89141-3837
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Country | US
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Telephone | 702-425-3243
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 230696
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City | LAS VEGAS
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State | NV
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Zip | 89123
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Country | US
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Telephone | 702-425-3243
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Fax | 702-430-1681
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Authorized Official
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Title or Position | CEO
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Name | MS. JODI ENGAN
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Credential |
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Telephone | 702-425-3243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1008049573
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License Number State | NV
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