Provider Demographics
NPI:1467126391
Name:TTF GROUP DBA PLAXIA CARE
Entity Type:Organization
Organization Name:TTF GROUP DBA PLAXIA CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CROCK
Authorized Official - Suffix:
Authorized Official - Credentials:RFA
Authorized Official - Phone:702-858-4559
Mailing Address - Street 1:5095 N PARK ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-2522
Mailing Address - Country:US
Mailing Address - Phone:702-858-4559
Mailing Address - Fax:
Practice Address - Street 1:5095 N PARK ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-2522
Practice Address - Country:US
Practice Address - Phone:702-858-4559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)