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General NPI Number Information
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NPI Number | 1801215033
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Entity Type | Organization
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Legal Business Name | CARE GOLD, LLC
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 3650 S DECATUR BLVD #23
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City | LAS VEGAS
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State | NV
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Zip | 89103-5864
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Country | US
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Telephone | 702-781-0868
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Fax | 866-529-1497
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Provider Business Mailing Address
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Address Line | 3650 S DECATUR BLVD #23
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City | LAS VEGAS
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State | NV
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Zip | 89103-5864
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Country | US
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Telephone | 702-781-0868
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Fax | 866-529-1497
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. KAMATCHI ANBAZHAGAN
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Credential |
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Telephone | 702-781-0868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 13978
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License Number State | NV
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