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General NPI Number Information
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NPI Number | 1740842582
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Entity Type | Organization
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Legal Business Name | JONATHAN C. BUENVIAJE LLC
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Dates
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Enumeration Date | 07/02/2019
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 327 RIVER FLOW DR
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City | RENO
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State | NV
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Zip | 89523
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Country | US
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Telephone | 775-787-7960
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Fax | 775-451-5011
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Provider Business Mailing Address
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Address Line | 327 RIVER FLOW DR
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City | RENO
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State | NV
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Zip | 89523
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Country | US
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Telephone | 775-787-7960
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Fax | 775-451-5011
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LAILA BUENVIAJE
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Credential | RFA
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Telephone | 775-432-3887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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