Provider Demographics
NPI:1730751496
Name:2CTN LLC
Entity type:Organization
Organization Name:2CTN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FABRICE
Authorized Official - Middle Name:OLUFEMI
Authorized Official - Last Name:AGUNBIADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-559-7851
Mailing Address - Street 1:4450 S HUALAPAI WAY UNIT 1079
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-7272
Mailing Address - Country:US
Mailing Address - Phone:316-559-7851
Mailing Address - Fax:
Practice Address - Street 1:4450 S HUALAPAI WAY UNIT 1079
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-7272
Practice Address - Country:US
Practice Address - Phone:316-559-7851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care