Provider Demographics
NPI:1780010918
Name:NEVADA PERSONAL CARE SERVICES INC
Entity Type:Organization
Organization Name:NEVADA PERSONAL CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GANIYU
Authorized Official - Middle Name:
Authorized Official - Last Name:SHITTU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-727-4090
Mailing Address - Street 1:PO BOX 211706
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99521-1706
Mailing Address - Country:US
Mailing Address - Phone:907-727-4090
Mailing Address - Fax:907-337-2079
Practice Address - Street 1:6615 S EASTERN AVE STE 104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119
Practice Address - Country:US
Practice Address - Phone:907-727-4090
Practice Address - Fax:702-722-6202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2020-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7417PCO-5251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health