OrganizationLions Crest LlcCommunity/Behavioral HealthAgenciesPractice Address5420 W Sahara Ave, Suite 102, Las Vegas, NV 89146-0394(702) 772-8892PECOS EnrollmentBased on the most recent information from CMS, provider Lions Crest Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1649537333Provider TypeOrganizationFull NameLions Crest LlcSubpartNoEnumeration Date4/18/2012Last Updated10/16/2013Contact InformationPractice LocationPractice Address5420 W Sahara Ave, Suite 102, Las Vegas, NV 89146-0394Phone(702) 772-8892FaxUnlisted FaxMailing LocationMailing Address5420 W Sahara Ave, Suite 102, Las Vegas, NV 89146-0394Phone(702) 772-8892FaxUnlisted FaxAuthorized OfficialNameCruz, Wascar (Owner)Phone(702) 772-8892Provider TaxonomiesCodeDescriptionLicenseCode251S00000XPrimaryDescriptionCommunity/Behavioral HealthAgenciesLicenseUnlisted IssuerCode261QM0801XDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseUnlisted IssuerCode261QM0855XDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseUnlisted Issuer