Individual
ELEANOR MORANDARTE ODEANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11292 ROMAN HELMET ST, LAS VEGAS, NV 89141-6210
(619) 985-8274
Mailing address
11292 ROMAN HELMET ST, LAS VEGAS, NV 89141-6210
(619) 985-8274
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/23/2024
Last updated
12/23/2024
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