Provider Demographics
NPI:1295627750
Name:LAS VEGAS MARK LLC
Entity type:Organization
Organization Name:LAS VEGAS MARK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:NAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-925-2430
Mailing Address - Street 1:10845 GRIFFITH PEAK DR STE 2-115
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-1553
Mailing Address - Country:US
Mailing Address - Phone:216-925-2430
Mailing Address - Fax:
Practice Address - Street 1:10845 GRIFFITH PEAK DR STE 2-115
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135-1553
Practice Address - Country:US
Practice Address - Phone:216-925-2430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care