Provider Demographics
NPI:1528617818
Name:CONTRERAS, AMANDA LUCRECIA
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LUCRECIA
Last Name:CONTRERAS
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:SAFE AT HOME LLC
Mailing Address - Street 2:1775 E TROPICANA AVE STE 16
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119
Mailing Address - Country:US
Mailing Address - Phone:702-916-4904
Mailing Address - Fax:
Practice Address - Street 1:SAFE AT HOME LLC
Practice Address - Street 2:1775 E TROPICANA AVE STE 16
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119
Practice Address - Country:US
Practice Address - Phone:702-916-4904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion