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Organization

PINEDA GROUP LLC

Active
Other names
MYSTIC HAVEN
Organization subpart
No

Provider details

NPI number
Authorized official
YANNIE TABLIZO (MANAGING MEMBER)
(702) 302-6932
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
05/13/2019
Last updated
05/13/2019
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