Organization
AVANA PERSONAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS GENESIS S BAUTISTA (ADMINISTRATOR)
(702) 347-7432
Entity
Organization
Contact information
Practice address
4550 W OAKEY BLVD # 111-R, LAS VEGAS, NV 89102-1581
(702) 347-7432
(702) 447-7122
Mailing address
4550 W OAKEY BLVD # 111-R, LAS VEGAS, NV 89102-1581
(702) 347-7432
(702) 447-7122
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
8613-PCS-0
NV
Other
Enumeration date
01/11/2017
Last updated
01/11/2017
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