Provider Demographics
NPI:1407276397
Name:DD PERSONAL CARE LLC
Entity Type:Organization
Organization Name:DD PERSONAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADISNUBIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VEGA-RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-207-0842
Mailing Address - Street 1:2000 S EASTERN AVE STE 1020
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-4100
Mailing Address - Country:US
Mailing Address - Phone:702-207-0842
Mailing Address - Fax:702-207-0357
Practice Address - Street 1:3468 E SAHARA AVE STE 165
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-4827
Practice Address - Country:US
Practice Address - Phone:702-207-0842
Practice Address - Fax:702-207-0357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-18
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7755PCS-0253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care