Organization
PERIWINKLE GROUP LLC
Active
Other names
OTAC Health Managment
Organization subpart
No
Provider details
NPI number
Authorized official
JO CATO (CEO)
(702) 657-6500
Entity
Organization
Contact information
Practice address
4270 CAMERON ST, 3A, LAS VEGAS, NV 89103-7704
(702) 657-6500
(702) 664-0502
Mailing address
4270 CAMERON ST, 3A, LAS VEGAS, NV 89103-7704
(702) 657-6500
(702) 664-0502
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
NV
Other
Enumeration date
10/30/2015
Last updated
03/10/2017
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