Organization
BABY BOOMERS ACTIVITIES CLUB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIUSHKA LOZANO DE POSADA (MANAGING MEMBER)
(702) 878-9600
Entity
Organization
Contact information
Practice address
850 S JONES BLVD, LAS VEGAS, NV 89107-3730
(702) 878-9600
Mailing address
850 S JONES BLVD, LAS VEGAS, NV 89107-3730
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
5152ADC-10
NV
Other
Enumeration date
04/20/2016
Last updated
11/08/2018
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