Provider Demographics
NPI:1740842582
Name:JONATHAN C. BUENVIAJE LLC
Entity type:Organization
Organization Name:JONATHAN C. BUENVIAJE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUENVIAJE
Authorized Official - Suffix:
Authorized Official - Credentials:RFA
Authorized Official - Phone:775-432-3887
Mailing Address - Street 1:327 RIVER FLOW DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523
Mailing Address - Country:US
Mailing Address - Phone:775-787-7960
Mailing Address - Fax:775-451-5011
Practice Address - Street 1:327 RIVER FLOW DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523
Practice Address - Country:US
Practice Address - Phone:775-787-7960
Practice Address - Fax:775-451-5011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-02
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home