Provider Demographics
NPI:1568045755
Name:VANDA'S NEWLIFE CARE SERVICES LLC
Entity type:Organization
Organization Name:VANDA'S NEWLIFE CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CALVETTA
Authorized Official - Middle Name:LAQUITA
Authorized Official - Last Name:BRUTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-426-6886
Mailing Address - Street 1:7320 S RAINBOW BLVD STE 102-559
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-0406
Mailing Address - Country:US
Mailing Address - Phone:800-705-5043
Mailing Address - Fax:
Practice Address - Street 1:7320 S RAINBOW BLVD STE 102-559
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-0406
Practice Address - Country:US
Practice Address - Phone:800-705-5043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VANDA'S NEWLIFE CARE SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-04
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health