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NPI Code Detail

MEDICARE: ALISSAS PERSONAL CARE SERVICESLLC

MEDICARE: ALISSAS PERSONAL CARE SERVICESLLC
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 Attendant

General Provider Information

NPI Number : 1164936605
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALISSAS PERSONAL CARE SERVICESLLC
Provider Business Mailing Address
First Line : 1650 E SAHARA AVE STE 1
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-3495
Country : US
Telephone Number : 702-265-8130
Fax Number :
Provider Business Practice Location Address
First Line : 1650 E SAHARA AVE STE 1
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-3495
Country : US
Telephone Number : 702-265-8130
Fax Number :
Authorized Official
Title or Position : CEO
Name : SONIA LOPEZ
Credential :
Telephone Number : 702-265-8130
Provider Enumeration Date : 11/20/2017
Last Update Date : 11/20/2017

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Directions to “ALISSAS PERSONAL CARE SERVICESLLC ” Practice Location

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