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General NPI Number Information
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NPI Number | 1962791897
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Entity Type | Organization
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Legal Business Name | ADULT DAY CARE OF LAS VEGAS
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Dates
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Enumeration Date | 03/31/2011
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Last Update Date | 03/31/2011
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Provider Practice Location Address
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Address Line | 953 E SAHARA AVE #A-7 A-8
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City | LAS VEGAS
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State | NV
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Zip | 89104
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Country | US
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Telephone | 702-501-6072
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Fax | 702-734-2258
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Provider Business Mailing Address
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Address Line | 953 E SAHARA AVE # A-7A8
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City | LAS VEGAS
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State | NV
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Zip | 89104-3005
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Country | US
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Telephone | 702-501-6072
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Fax | 702-734-2258
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Authorized Official
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Title or Position | MANAGER
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Name | MISS LORRAINE DURAN
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Credential |
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Telephone | 702-501-6072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 6057ADC-0
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License Number State | NV
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