Provider Demographics
NPI:1093186553
Name:21ST CENTURY MOVES LLC
Entity Type:Organization
Organization Name:21ST CENTURY MOVES LLC
Other - Org Name:ANCHM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER & MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RO
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-445-3307
Mailing Address - Street 1:245 E CENTENNIAL PKWY # 23-3116
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-1354
Mailing Address - Country:US
Mailing Address - Phone:949-445-3307
Mailing Address - Fax:
Practice Address - Street 1:245 E CENTENNIAL PKWY # 23-3116
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-1354
Practice Address - Country:US
Practice Address - Phone:949-445-3307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-09
Last Update Date:2016-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20151563054305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service