NPIMap

Organization Active NPI

Baby Boomers Activities Club, LLC

  • Adult Day Care Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1184078784
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
5152ADC-10 Issued in NV
Legal business name
BABY BOOMERS ACTIVITIES CLUB, LLC
Practice address
850 S Jones Blvd
Las Vegas, NV 89107-3730
Phone
(702) 878-9600
NPI assigned
Apr 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Katiushka Lozano de Posada
Title
Managing Member
Phone
(702) 878-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 5152ADC-10 NV Primary

Addresses

Primary practice location

850 S Jones Blvd
Las Vegas, NV 89107-3730

Mailing address

850 S Jones Blvd
Las Vegas, NV 89107-3730

National Provider Directory

National Provider Directory
Tax ID family
Baby Boomers Activities Club LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541635200000",
    "number": "1184078784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891073730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891073730",
            "telephone_number": "702-878-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BABY BOOMERS ACTIVITIES CLUB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-20",
        "last_updated": "2018-11-08",
        "status": "A",
        "authorized_official_last_name": "LOZANO DE POSADA",
        "authorized_official_first_name": "KATIUSHKA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "702-878-9600"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NV",
            "license": "5152ADC-10",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.