Provider Demographics
NPI:1083172779
Name:LAS VEGAS PERSONAL CARE
Entity Type:Organization
Organization Name:LAS VEGAS PERSONAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YANISEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BENITEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-972-2246
Mailing Address - Street 1:4350 ARVILLE ST STE 40
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-3811
Mailing Address - Country:US
Mailing Address - Phone:702-202-3184
Mailing Address - Fax:
Practice Address - Street 1:4350 ARVILLE ST STE 40
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-3811
Practice Address - Country:US
Practice Address - Phone:702-202-3184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAS VEGAS PERSONAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-12
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty