Provider Demographics
NPI:1295512234
Name:JONATHAN BUENVIAJE
Entity type:Organization
Organization Name:JONATHAN BUENVIAJE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUENVIAJE
Authorized Official - Suffix:
Authorized Official - Credentials:RFA
Authorized Official - Phone:775-432-3887
Mailing Address - Street 1:1254 SAINT ALBERTS DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503
Mailing Address - Country:US
Mailing Address - Phone:775-746-4419
Mailing Address - Fax:775-451-5011
Practice Address - Street 1:1254 SAINT ALBERTS DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503
Practice Address - Country:US
Practice Address - Phone:775-746-4419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home