MEDICARE: ADDE PCA CARE, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	376J00000X	Homemaker
3	385H00000X	Respite Care
4	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1326873662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADDE PCA CARE, INC

Provider Business Mailing Address
First Line	:	2610 S JONES BLVD STE D
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5663
Country	:	US
Telephone Number	:	725-599-3880
Fax Number	:	702-213-9064

Provider Business Practice Location Address
First Line	:	2610 S JONES BLVD STE D
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-5663
Country	:	US
Telephone Number	:	725-599-3880
Fax Number	:	702-213-9064

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. YENDI NAYELI LOPEZ
Credential	:
Telephone Number	:	702-575-3138

Provider Enumeration Date	:	09/05/2024
Last Update Date	:	09/05/2024

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Directions to “ADDE PCA CARE, INC ” Practice Location

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