Organization
LIFESHARE CARE HOME NEVADA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BELINDA DEVANO (PRESIDENT/ADMINISTRATOR)
(408) 854-0735
Entity
Organization
Contact information
Practice address
7925 W ROSADA WAY, LAS VEGAS, NV 89149-5208
(702) 722-6783
(702) 998-0280
Mailing address
2795 GEORGE BLAUER PL, SAN JOSE, CA 95135-1281
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
6087AGC-6
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9005057235
—
NV
Enumeration date
01/12/2016
Last updated
01/12/2016
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