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General NPI Number Information
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NPI Number | 1801247952
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Entity Type | Organization
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Legal Business Name | FAMILY PERSONAL CARE, LLC
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Dates
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Enumeration Date | 06/29/2016
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Last Update Date | 06/29/2016
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Provider Practice Location Address
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Address Line | 4550 W OAKEY BLVD STE 108A
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City | LAS VEGAS
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State | NV
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Zip | 89102-1506
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Country | US
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Telephone | 702-906-1999
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Fax |
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Provider Business Mailing Address
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Address Line | 4550 W OAKEY BLVD STE 108A
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City | LAS VEGAS
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State | NV
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Zip | 89102-1506
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Country | US
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Telephone | 702-906-1999
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JUAN A AVILA
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Credential |
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Telephone | 702-906-1999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 8062PCS3
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License Number State | NV
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