Provider Demographics
NPI:1831874379
Name:GOOD VIBES PERSONAL CARE LLC
Entity type:Organization
Organization Name:GOOD VIBES PERSONAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YAMILYS
Authorized Official - Middle Name:
Authorized Official - Last Name:NEPOMUCENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-686-2480
Mailing Address - Street 1:6028 GOLDEN NECTAR WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142-0623
Mailing Address - Country:US
Mailing Address - Phone:702-686-2480
Mailing Address - Fax:
Practice Address - Street 1:6028 GOLDEN NECTAR WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89142-0623
Practice Address - Country:US
Practice Address - Phone:702-686-2480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health