Basic Information
Provider Information
NPI: 1346895281
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARZOLA
FirstName: CARLOS
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 70 E HORIZON RIDGE PKWY STE 100
Address2:  
City: HENDERSON
State: NV
PostalCode: 890027936
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 70 E HORIZON RIDGE PKWY STE 100
Address2:  
City: HENDERSON
State: NV
PostalCode: 890027936
CountryCode: US
TelephoneNumber: 7026443600
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/07/2019
LastUpdateDate: 08/07/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
372500000X NVN Nursing Service Related ProvidersChore Provider 
372600000X NVN Nursing Service Related ProvidersAdult Companion 
3747A0650X NVN Nursing Service Related ProvidersTechnicianAttendant Care Provider
376J00000X  N Nursing Service Related ProvidersHomemaker 
3747P1801X NVY Nursing Service Related ProvidersTechnicianPersonal Care Attendant

No ID Information.


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