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General NPI Number Information
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NPI Number | 1871846949
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Entity Type | Organization
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Legal Business Name | JOREN LLC
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Dates
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Enumeration Date | 10/25/2012
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 4440 E SAINT LOUIS AVE
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City | LAS VEGAS
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State | NV
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Zip | 89104-5646
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Country | US
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Telephone | 702-461-6969
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Fax | 702-431-4143
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Provider Business Mailing Address
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Address Line | 4440 E SAINT LOUIS AVE
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City | LAS VEGAS
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State | NV
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Zip | 89104-5646
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Country | US
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Telephone | 702-461-6969
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Fax | 702-431-4143
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Authorized Official
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Title or Position | MANAGER
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Name | THELMA BALINGIT
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Credential |
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Telephone | 702-461-6969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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