Organization
INTERNATIONAL ADULT DAY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DELIA R GONZALEZ M.A (CREDENTIALING/BILLING)
(702) 258-4900
Entity
Organization
Contact information
Practice address
2215 RENAISSANCE DR, STE A, LAS VEGAS, NV 89119-6163
(702) 405-6393
(702) 405-6564
Mailing address
2215 RENAISSANCE DR, STE A, LAS VEGAS, NV 89119-6163
(702) 405-6393
(702) 405-6564
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
2014159531
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477632685
—
NV
05
—
1972792075
—
NV
Enumeration date
02/17/2016
Last updated
02/17/2016
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