Provider Demographics
NPI:1922468214
Name:CLAUDETTE ANDREWS
Entity Type:Organization
Organization Name:CLAUDETTE ANDREWS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-410-1940
Mailing Address - Street 1:3465 NOWLIN LN
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-1371
Mailing Address - Country:US
Mailing Address - Phone:775-410-1940
Mailing Address - Fax:
Practice Address - Street 1:3465 NOWLIN LN
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-1371
Practice Address - Country:US
Practice Address - Phone:775-410-1940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9005049083Medicaid