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General NPI Number Information
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NPI Number | 1629842935
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Entity Type | Organization
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Legal Business Name | INFINITE CARE LLC
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Dates
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Enumeration Date | 11/08/2023
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Last Update Date | 11/08/2023
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Provider Practice Location Address
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Address Line | 3821 TOPAZ ST
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City | LAS VEGAS
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State | NV
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Zip | 89121-4139
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Country | US
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Telephone | 702-722-2896
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Fax |
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Provider Business Mailing Address
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Address Line | 6589 SWEETZER WAY
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City | LAS VEGAS
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State | NV
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Zip | 89108-7316
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | IRRAH COMIA
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Credential |
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Telephone | 725-300-2589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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