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General NPI Number Information
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NPI Number | 1538707005
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Entity Type | Organization
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Legal Business Name | NEUBIANS QUEEN CROWN AND GLORY, INCORP.
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Dates
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Enumeration Date | 12/16/2019
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Last Update Date | 12/16/2019
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Provider Practice Location Address
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Address Line | 5550 PAINTED MIRAGE RD STE 320
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City | LAS VEGAS
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State | NV
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Zip | 89149-4584
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Country | US
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Telephone | 702-202-5857
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 335724
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City | LAS VEGAS
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State | NV
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Zip | 89133
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Country | US
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Telephone | 702-670-8984
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ONESIA HARDING
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Credential | FOUNDER
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Telephone | 702-202-5857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247200000X
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Taxonomy Name | Other Technician
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License Number |
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License Number State |
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