Organization
ELSUBE LLC
Active
Other names
San Antonio Personal Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELODIA MAYNARD (MANAGER)
(702) 643-1552
Entity
Organization
Contact information
Practice address
4132 SOLAR SYSTEM ST., NORT LAS VEGAS, NV 89032-0753
(702) 619-1859
(702) 463-0104
Mailing address
417 FOXVALE AVE., NORTH LAS VEGAS, NV 89032-6150
(702) 643-1552
(702) 463-0104
Taxonomy
Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
20121700531
NV
Other
Enumeration date
08/14/2015
Last updated
08/14/2015
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