Provider Demographics
NPI:1023414232
Name:A PLACE CALLED HOME
Entity type:Organization
Organization Name:A PLACE CALLED HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:APRL
Authorized Official - Middle Name:CELESTE
Authorized Official - Last Name:ARAQUIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-381-4774
Mailing Address - Street 1:3752 BOSSA NOVA DR
Mailing Address - Street 2:3308 SALMON CREEK
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-6800
Mailing Address - Country:US
Mailing Address - Phone:702-381-4774
Mailing Address - Fax:
Practice Address - Street 1:3308 SALMON CREEK DR
Practice Address - Street 2:3752 BOSSA NOVA DR
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6186
Practice Address - Country:US
Practice Address - Phone:702-381-4774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-16
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV251B00000X, 251S00000X, 302F00000X, 251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No302F00000XManaged Care OrganizationsExclusive Provider Organization