1639537269 NPI number — SKILLS 4 KIDS LLC

Table of content: (NPI 1639537269)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639537269 NPI number — SKILLS 4 KIDS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SKILLS 4 KIDS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1639537269
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/10/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9101 W SAHARA AVE
Provider Second Line Business Mailing Address:
SUITE 105-A5
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89117-5772
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-232-9533
Provider Business Mailing Address Fax Number:
702-538-9977

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7456 W SAHARA AVE
Provider Second Line Business Practice Location Address:
SUITE 102-A
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89117-2792
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-232-9533
Provider Business Practice Location Address Fax Number:
702-538-9977
Provider Enumeration Date:
02/10/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FRAZIER
Authorized Official First Name:
LINA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER DIRECTOR
Authorized Official Telephone Number:
702-232-9533

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  NV20081588006 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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