# PINEDA GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MYSTIC HAVEN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205492568
- **Authorized official:** YANNIE TABLIZO (MANAGING MEMBER)
- **Authorized official phone:** (702) 302-6932

## Contact information

- **Practice address:** 3421 CAMSORE POINT LN, LAS VEGAS, NV 89129-6999
- **Practice address phone:** (702) 255-9171
- **Practice address fax:** (702) 202-3680
- **Mailing address:** 4325 N TORREY PINES DR, LAS VEGAS, NV 89108-5510
- **Mailing address phone:** (702) 658-5518
- **Mailing address fax:** (702) 202-3680

## Taxonomy

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

## Other

- **Enumeration date:** 05/13/2019
- **Last updated:** 05/13/2019