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NPI Code Detail

MEDICARE: AZURE GROUP HOME

MEDICARE: AZURE GROUP HOME
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
1251B00000XCase Management Agency
2251C00000XDevelopmentally Disabled Services Day Training Agency

General Provider Information

NPI Number : 1588745038
Entity Type Code : Organization
Provider Name (Legal Business Name) : AZURE GROUP HOME
Provider Business Mailing Address
First Line : 4180 S PECOS RD
Second Line : SUITE 115
City : LAS VEGAS
State : NV
Zip : 89121-5074
Country : US
Telephone Number : 702-433-5368
Fax Number : 702-434-2485
Provider Business Practice Location Address
First Line : 4180 S PECOS RD
Second Line : SUITE 115
City : LAS VEGAS
State : NV
Zip : 89121-5074
Country : US
Telephone Number : 702-433-5368
Fax Number : 702-434-2485
Authorized Official
Title or Position : ADMINISTRATOR/PRESIDENT/OWNER
Name : MS. YELENA YEKTA
Credential :
Telephone Number : 702-433-5368
Provider Enumeration Date : 10/18/2006
Last Update Date : 09/11/2025

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Directions to “AZURE GROUP HOME ” Practice Location

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