Provider Demographics
NPI:1285181073
Name:MELAJ CARE LLC
Entity type:Organization
Organization Name:MELAJ CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR / MANAGER / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MEROLO
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRERA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:818-207-8602
Mailing Address - Street 1:5733 CLARENDON LN
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-2424
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2770 S MARYLAND PKWY
Practice Address - Street 2:SUITE #214
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-1554
Practice Address - Country:US
Practice Address - Phone:702-836-3444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8597-PCS-0253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care