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General NPI Number Information
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NPI Number | 1861806408
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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 | 06/11/2014
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Last Update Date | 09/13/2019
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Provider Practice Location Address
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Address Line | 2415 REYNOLDS AVE STE 101
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030-7279
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Country | US
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Telephone | 702-906-1999
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Fax | 702-906-1998
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Provider Business Mailing Address
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Address Line | 2415 REYNOLDS AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030-7278
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Country | US
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Telephone | 702-906-1999
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Fax | 702-906-1998
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Authorized Official
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Title or Position | MANGING MANAGER
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Name | JUAN ALBERTO 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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | NV20111669090
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License Number State | NV
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