Provider Demographics
NPI:1104468339
Name:SALAZAR, ALMA LETICIA
Entity type:Individual
Prefix:
First Name:ALMA
Middle Name:LETICIA
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 S JONES BLVD UNIT 2089
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-3353
Mailing Address - Country:US
Mailing Address - Phone:702-702-6953
Mailing Address - Fax:
Practice Address - Street 1:SAFE AT HOME, LLC
Practice Address - Street 2:1775 E. TROPICANA AVE. SUIT 16-B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119
Practice Address - Country:US
Practice Address - Phone:702-916-4904
Practice Address - Fax:702-916-4904
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide