Basic Information
Provider Information
NPI: 1710480801
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NAPOLEON
FirstName: LOUIS
MiddleName: DONALD
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5805 W HARMON AVE SPC 36
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891034863
CountryCode: US
TelephoneNumber: 7023263436
FaxNumber:  
Practice Location
Address1: 3101 W CHARLESTON BLVD
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891021931
CountryCode: US
TelephoneNumber: 7028392060
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/14/2018
LastUpdateDate: 03/14/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X  Y AgenciesHome Health 

ID Information
IDTypeStateIssuerDescription
PCA0512554405NV MEDICAID
PCA0512554401NVA HELPING HANDOTHER


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