MEDICARE: PROMISE LAND ENTERPRISE 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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1922710474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROMISE LAND ENTERPRISE LLC

Provider Business Mailing Address
First Line	:	5639 OAK BEND DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89135-1228
Country	:	US
Telephone Number	:	559-977-7971
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 BELLEAU ST
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38127-4422
Country	:	US
Telephone Number	:	559-977-7971
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ZEBRINA GRAVES
Credential	:
Telephone Number	:	559-977-7971

Provider Enumeration Date	:	12/15/2022
Last Update Date	:	02/25/2026

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Directions to “PROMISE LAND ENTERPRISE LLC ” Practice Location

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