=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518538214
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TWAIN ADULT DAY CARE CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/05/2021
-----------------------------------------------------
Last Update Date | 05/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 855 E TWAIN AVE STE 105
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89169-0820
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-728-0208
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6153 YUZU PL
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89122-7777
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-497-3986
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MISS CHRISTINE MARAPAO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 626-497-3986
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------