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General NPI Number Information
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NPI Number | 1760210173
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Entity Type | Organization
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Legal Business Name | VITAL RESTORATIVE CARE LLC
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Dates
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Enumeration Date | 07/25/2024
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 8880 W SUNSET RD STE 175
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City | LAS VEGAS
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State | NV
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Zip | 89148-5004
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Country | US
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Telephone | 702-463-8548
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Fax |
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Provider Business Mailing Address
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Address Line | 8880 W SUNSET RD STE 175
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City | LAS VEGAS
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State | NV
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Zip | 89148-5004
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Country | US
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Telephone | 702-463-8548
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAHRA MAY KATO
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Credential | NP
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Telephone | 818-633-2369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty 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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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