Provider Demographics
NPI:1154977940
Name:LEON-LOPEZ, DEVORA SUSANA
Entity type:Individual
Prefix:
First Name:DEVORA
Middle Name:SUSANA
Last Name:LEON-LOPEZ
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 1:3620 N. RANCHO DR SUITE 117
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130
Mailing Address - Country:US
Mailing Address - Phone:725-251-3737
Mailing Address - Fax:725-251-5797
Practice Address - Street 1:FINE STAR HOME CARE SERVICES
Practice Address - Street 2:3620 N. RANCHO DR SUITE 117
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130
Practice Address - Country:US
Practice Address - Phone:725-251-3737
Practice Address - Fax:725-251-5797
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No376J00000XNursing Service Related ProvidersHomemaker