Provider Demographics
NPI:1386443927
Name:SPENCER LUXURY CARE LLC
Entity type:Organization
Organization Name:SPENCER LUXURY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:REY EDRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:VASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-741-2123
Mailing Address - Street 1:1951 PAPAGO LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-3352
Mailing Address - Country:US
Mailing Address - Phone:702-540-0162
Mailing Address - Fax:725-204-5785
Practice Address - Street 1:1951 PAPAGO LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-3352
Practice Address - Country:US
Practice Address - Phone:702-540-0162
Practice Address - Fax:725-204-5785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home