Provider Demographics
NPI:1215364922
Name:JEWEL DEGUZMAN
Entity Type:Organization
Organization Name:JEWEL DEGUZMAN
Other - Org Name:CASSELS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEWEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEGUZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OA
Authorized Official - Phone:702-201-8585
Mailing Address - Street 1:2224 CANARY WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-1912
Mailing Address - Country:US
Mailing Address - Phone:702-201-8585
Mailing Address - Fax:
Practice Address - Street 1:2224 CANARY WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-1912
Practice Address - Country:US
Practice Address - Phone:702-201-8585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV59Medicaid