Organization
FOREVER LIVING RESIDENCE HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA ESCOBAR (OWNER)
(702) 331-1695
Entity
Organization
Contact information
Practice address
1608 AZTEC WAY, LAS VEGAS, NV 89169-3168
(702) 990-1624
Mailing address
1608 AZTEC WAY, LAS VEGAS, NV 89169-3168
(702) 990-1624
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
7507 AGC-6
NV
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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