Provider Demographics
NPI:1225512080
Name:CALAS, MIRKA
Entity Type:Individual
Prefix:
First Name:MIRKA
Middle Name:
Last Name:CALAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1237 DIAMOND VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3019
Mailing Address - Country:US
Mailing Address - Phone:702-379-4660
Mailing Address - Fax:
Practice Address - Street 1:1237 DIAMOND VALLEY ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3019
Practice Address - Country:US
Practice Address - Phone:702-379-4660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care