Organization · NPI-2

1st Advance Home Care

In Home Supportive Care · Las Vegas, NV

NPI number1659768745
StatusActive
Last updated in NPPESApr 16, 2015

Details

NPI
1659768745
Entity type
Organization (NPI-2)
Legal business name
1st Advance Home Care
Organization subpart
No
Enumeration date
Apr 16, 2015
Last updated
Apr 16, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
253Z00000X In Home Supportive CareNV20141435807NVYes

Practice location

6392 Mcleod Dr
Suite 7
Las Vegas, NV 89120-4416

Phone 702-795-4357

Mailing address

6392 Mcleod Dr
Suite 7
Las Vegas, NV 89120-4416

Authorized official

Joandra Cornelius-Johnson
Administrator
7023268594

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