Organization
5 STAR DISABILITY SERVICES LV LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHIMEZIE MADUKA (EXECUTIVE OFFICER)
(702) 574-0272
Entity
Organization
Contact information
Practice address
11441 ALLERTON PARK DR, LAS VEGAS, NV 89135-3374
(702) 872-2700
Mailing address
11441 ALLERTON PARK DR UNIT 218, LAS VEGAS, NV 89135-3375
(702) 872-2700
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
05/05/2022
Last updated
07/05/2023
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