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NPI Code Detail

MEDICARE: TRANSITION HEALTH SERVICES-VIDA ENCANTADA, LLC

MEDICARE: TRANSITION HEALTH SERVICES-VIDA ENCANTADA, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1083932354
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRANSITION HEALTH SERVICES-VIDA ENCANTADA, LLC
Provider Business Mailing Address
First Line : 415 HIGHWAY 377 S
Second Line : SUITE 200
City : ARGYLE
State : TX
Zip : 76226-5140
Country : US
Telephone Number : 940-464-7010
Fax Number : 940-464-7011
Provider Business Practice Location Address
First Line : 2301 COLLINS DR
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-4826
Country : US
Telephone Number : 505-425-9362
Fax Number : 505-425-5414
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : MS. CHANA SHELTON
Credential :
Telephone Number : 940-464-7018
Provider Enumeration Date : 05/12/2010
Last Update Date : 05/12/2010

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Directions to “TRANSITION HEALTH SERVICES-VIDA ENCANTADA, LLC ” Practice Location

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