Provider Demographics
NPI:1396153722
Name:A-TEAM PERSONAL CARE, LLC
Entity type:Organization
Organization Name:A-TEAM PERSONAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:AVILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-822-1253
Mailing Address - Street 1:4550 W OAKEY BLVD
Mailing Address - Street 2:SUITE 111-E
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1581
Mailing Address - Country:US
Mailing Address - Phone:702-822-1253
Mailing Address - Fax:702-822-1336
Practice Address - Street 1:4550 W OAKEY BLVD
Practice Address - Street 2:SUITE 111-E
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1581
Practice Address - Country:US
Practice Address - Phone:702-822-1253
Practice Address - Fax:702-822-1336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7997PCS-0253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care