Provider Demographics
NPI:1851749071
Name:US NATIONAL PERSONAL CARE, LLC
Entity Type:Organization
Organization Name:US NATIONAL PERSONAL CARE, LLC
Other - Org Name:US NATIONAL PERSONAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-253-1031
Mailing Address - Street 1:2881 S VALLEY VIEW BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-0171
Mailing Address - Country:US
Mailing Address - Phone:702-253-1031
Mailing Address - Fax:
Practice Address - Street 1:2881 S VALLEY VIEW BLVD STE 6
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-0171
Practice Address - Country:US
Practice Address - Phone:702-253-1031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1083091151Medicaid
NV9005055965Medicaid
NV1891158911Medicaid