# HOLY ANGEL CARE HOME, LLC

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

## Provider details

- **NPI number:** 1578047429
- **Authorized official:** ROSALIE AQUINO (MANAGER)
- **Authorized official phone:** (702) 443-1964

## Contact information

- **Practice address:** 1517 GENTLE BROOK ST, NORTH LAS VEGAS, NV 89084-2031
- **Practice address phone:** (702) 443-1964
- **Mailing address:** 1517 GENTLE BROOK ST, NORTH LAS VEGAS, NV 89084-2031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 09/17/2018
- **Last updated:** 09/17/2018