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General NPI Number Information
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NPI Number | 1730921115
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Entity Type | Organization
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Legal Business Name | VEGAS LIGHT CARE PCA LLC
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Dates
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Enumeration Date | 06/07/2024
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 9363 VITAL CREST ST
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City | LAS VEGAS
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State | NV
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Zip | 89123-7619
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Country | US
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Telephone | 702-300-8862
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Fax |
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Provider Business Mailing Address
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Address Line | 9363 VITAL CREST ST
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City | LAS VEGAS
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State | NV
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Zip | 89123-7619
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Country | US
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Telephone | 702-300-8862
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Fax |
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Authorized Official
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Title or Position | ADMIN
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Name | KARIM NASSAR
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Credential |
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Telephone | 702-831-7921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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