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General NPI Number Information
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NPI Number | 1831768746
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Entity Type | Organization
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Legal Business Name | MARQUES SMITH
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Dates
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Enumeration Date | 06/24/2021
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 3925 N MARTIN LUTHER KING BLVD SUITE 218
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032
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Country | US
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Telephone | 702-636-6412
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Fax | 702-636-6055
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Provider Business Mailing Address
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Address Line | 3925 N MARTIN LUTHER KING BLVD SUITE 218
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032
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Country | US
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Telephone | 702-636-6412
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Fax | 702-636-6055
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Authorized Official
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Title or Position | OWNER
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Name | MARQUES SMITH
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Credential |
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Telephone | 702-336-4066
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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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