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NPI Code Detail

MEDICARE: 1ST PARADISE PERSONAL CARE, LLC

MEDICARE: 1ST PARADISE PERSONAL CARE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care AttendantNV

General Provider Information

NPI Number : 1033629746
Entity Type Code : Organization
Provider Name (Legal Business Name) : 1ST PARADISE PERSONAL CARE, LLC
Provider Business Mailing Address
First Line : 3230 POLARIS AVE STE 2
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-8325
Country : US
Telephone Number : 702-678-5089
Fax Number :
Provider Business Practice Location Address
First Line : 3230 POLARIS AVE STE 2
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-8325
Country : US
Telephone Number : 702-678-5089
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : ROSALI CORDERO-REYNALDO
Credential :
Telephone Number : 702-826-8424
Provider Enumeration Date : 10/08/2017
Last Update Date : 04/04/2021

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Directions to “1ST PARADISE PERSONAL CARE, LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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