Provider Demographics
NPI:1205727294
Name:OBA 2 LLC
Entity type:Organization
Organization Name:OBA 2 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:OBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-471-7723
Mailing Address - Street 1:6755 W CHARLESTON BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-9000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6755 W CHARLESTON BLVD STE B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-9000
Practice Address - Country:US
Practice Address - Phone:775-471-7723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health