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Organization
UNITICARE
Active
Organization
UNITICARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMNNIQUE RICE-MILLER (DIRECTOR)
(570) 369-6642
Entity
Organization
Contact information
Practice address
10116 MARVEL COVE ST, LAS VEGAS, NV 89141-8771
(702) 912-8981
Mailing address
10116 MARVEL COVE ST, LAS VEGAS, NV 89141-8771
(702) 912-8981
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
NULL
Other
Enumeration date
05/06/2021
Last updated
05/10/2021
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