# PLAXIA CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013519073
- **Authorized official:** NICHOLE CROCK ADMINISTRATOR (OWNER)
- **Authorized official phone:** (702) 858-4559

## Contact information

- **Practice address:** 5095 N PARK ST, LAS VEGAS, NV 89149-2522
- **Practice address phone:** (702) 858-4559
- **Practice address fax:** (810) 885-0572
- **Mailing address:** 4565 N CHIEFTAIN ST, LAS VEGAS, NV 89129-2608
- **Mailing address phone:** (702) 858-4559
- **Mailing address fax:** (810) 885-0572

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 11/13/2020
- **Last updated:** 11/13/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 10219-AGC-0 | HEALTH AND HUMAN SERVICES DIVISION OF PUBIC AND BEHAVIORAL HEALTH | NV |
| 01 | — | NV20191673366 | SECRETARY OF STATE | NV |