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NPI Code Detail

MEDICARE: 702 POINT PLACE

MEDICARE: 702 POINT PLACE
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
1320700000XPhysical Disabilities Residential Treatment Facility

General Provider Information

NPI Number : 1841825346
Entity Type Code : Organization
Provider Name (Legal Business Name) : 702 POINT PLACE
Provider Business Mailing Address
First Line : 9856 POPLAR POINT AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89178-6315
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9856 POPLAR POINT AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89178-6315
Country : US
Telephone Number : 702-328-4634
Fax Number :
Authorized Official
Title or Position : OWNER
Name : AMBER SUAREZ
Credential :
Telephone Number : 702-328-4634
Provider Enumeration Date : 03/05/2020
Last Update Date : 12/28/2020

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Directions to “702 POINT PLACE ” Practice Location

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