Provider Demographics
NPI:1447745757
Name:BEAUTIFUL REFLECTIONS HOME CARE
Entity Type:Organization
Organization Name:BEAUTIFUL REFLECTIONS HOME CARE
Other - Org Name:BEAUTIFUL REFLECTIONS HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:QUANIKA
Authorized Official - Middle Name:SHUNTAAYE
Authorized Official - Last Name:SIMPSON-JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-417-4702
Mailing Address - Street 1:2020 PINTO LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4019
Mailing Address - Country:US
Mailing Address - Phone:702-417-4702
Mailing Address - Fax:
Practice Address - Street 1:4375 LAS VEGAS BLVD N
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89115-0587
Practice Address - Country:US
Practice Address - Phone:702-417-4702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-28
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care