Provider Demographics
NPI:1629541529
Name:NEW SUNSET PERSONAL CARE LLC
Entity Type:Organization
Organization Name:NEW SUNSET PERSONAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ALFEREZ
Authorized Official - Last Name:DECARDENAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-296-2532
Mailing Address - Street 1:3355 SPRING MOUNTAIN RD STE 47
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-8635
Mailing Address - Country:US
Mailing Address - Phone:702-444-1442
Mailing Address - Fax:702-444-2342
Practice Address - Street 1:3355 SPRING MOUNTAIN RD STE 47
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-8635
Practice Address - Country:US
Practice Address - Phone:702-444-1442
Practice Address - Fax:702-444-2342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV4100752244Medicaid