Organization
BABY BOOMERS ACTIVITIES CLUB II, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIUSHKA LOZANO DE POSADA (MANAGING MEMBER)
(702) 878-9600
Entity
Organization
Contact information
Practice address
1915 SIMMONS ST, BLD 26, LAS VEGAS, NV 89106-1666
(702) 878-9600
Mailing address
1915 SIMMONS ST, BLD 26, LAS VEGAS, NV 89106-1666
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
7787ACD-0
NV
Other
Enumeration date
04/20/2016
Last updated
11/08/2018
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