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General NPI Number Information
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NPI Number | 1619576964
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Entity Type | Organization
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Legal Business Name | NEVADA COMMUNITY CARE LLC
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Dates
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Enumeration Date | 10/19/2020
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 3430 E FLAMINGO RD STE 224
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City | LAS VEGAS
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State | NV
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Zip | 89121-5065
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Country | US
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Telephone | 702-742-5496
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Fax |
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Provider Business Mailing Address
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Address Line | 3615 SW 138TH CT
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City | MIAMI
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State | FL
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Zip | 33175-7227
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Country | US
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Telephone | 702-553-5033
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. YADISNAY GUADALUPE GARCIA
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Credential |
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Telephone | 702-553-5033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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