Organization
WHOLE LIFE PERSONAL CARE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCY M JACKSON MS (ADMINISTRATOR)
(702) 412-5175
Entity
Organization
Contact information
Practice address
2525 N DECATUR BLVD STE 2AND5, LAS VEGAS, NV 89108-2975
(702) 982-3636
(702) 982-3737
Mailing address
2525 N DECATUR BLVD STE 2AND5, LAS VEGAS, NV 89108-2975
(702) 982-3636
(702) 982-3737
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
NV201801659566
NV
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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