Organization
A HOME AWAY FROM HOME, LLC
Active
Other names
Away From Home Adult Care
Organization subpart
No
Provider details
NPI number
Authorized official
BRIEN SONSON (MANAGING MEMBER)
(702) 415-3284
Entity
Organization
Contact information
Practice address
1040 VIA DELL BACIO DR, HENDERSON, NV 89052-8728
(702) 415-3284
Mailing address
1040 VIA DELL BACIO DR, HENDERSON, NV 89052-8728
(702) 415-3284
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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