MEDICARE: SIMPLICITYBYADORE 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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1194485797
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMPLICITYBYADORE LLC

Provider Business Mailing Address
First Line	:	304 S JONES BLVD STE 1790
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-2623
Country	:	US
Telephone Number	:	951-531-6854
Fax Number	:

Provider Business Practice Location Address
First Line	:	304 S JONES BLVD STE 1790
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-2623
Country	:	US
Telephone Number	:	951-531-6854
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JIKILA MARQUISHA TRAHAN
Credential	:
Telephone Number	:	951-531-6854

Provider Enumeration Date	:	12/22/2021
Last Update Date	:	12/22/2021

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Directions to “SIMPLICITYBYADORE LLC ” Practice Location

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