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NPI Code Detail

MEDICARE: CPR247

MEDICARE: CPR247
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
1253J00000XFoster Care Agency
2253Z00000XIn Home Supportive Care Agency
3251E00000XHome Health Agency

General Provider Information

NPI Number : 1417359738
Entity Type Code : Organization
Provider Name (Legal Business Name) : CPR247
Provider Business Mailing Address
First Line : 2510 E SUNSET RD
Second Line : 5-568
City : LAS VEGAS
State : NV
Zip : 89120-3511
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2510 E SUNSET RD
Second Line : 5-568
City : LAS VEGAS
State : NV
Zip : 89120-3511
Country : US
Telephone Number : 702-619-6666
Fax Number :
Authorized Official
Title or Position : CEO
Name : AMANDA YAMAUCHI
Credential :
Telephone Number : 702-619-6666
Provider Enumeration Date : 09/17/2014
Last Update Date : 09/17/2014

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Directions to “CPR247 ” Practice Location

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