1316644230 NPI number — CRYSTAL RENEE CHAMBERS

Table of content: CRYSTAL RENEE CHAMBERS (NPI 1316644230)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316644230 NPI number — CRYSTAL RENEE CHAMBERS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAMBERS
Provider First Name:
CRYSTAL
Provider Middle Name:
RENEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316644230
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
NEW HOPE PERSONAL CARE , LLC
Provider Second Line Business Mailing Address:
3468 E SAHARA AVE STE 170
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-207-0842
Provider Business Mailing Address Fax Number:
702-207-0357

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
NEW HOPE PERSONAL CARE
Provider Second Line Business Practice Location Address:
3468 E SAHARA AVE STE 170
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89104-8910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-207-0842
Provider Business Practice Location Address Fax Number:
702-207-0357
Provider Enumeration Date:
02/10/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 372500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 372600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747A0650X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 376J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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