Provider Demographics
NPI:1932483716
Name:US NATIONAL PERSONAL CARE, LLC
Entity Type:Organization
Organization Name:US NATIONAL PERSONAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
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
Mailing Address - Street 2:SUITE # 22
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-0100
Mailing Address - Country:US
Mailing Address - Phone:702-253-1031
Mailing Address - Fax:702-253-9474
Practice Address - Street 1:2881 S VALLEY VIEW BLVD
Practice Address - Street 2:SUITE # 22
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-0100
Practice Address - Country:US
Practice Address - Phone:702-253-1031
Practice Address - Fax:702-253-9474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5317PCS-2251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9005055965Medicaid