MEDICARE: DESERT HEALTH CARE FACILITIES, INC.

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
1	314000000X	Skilled Nursing Facility	2343SNF13	NV
2	314000000X	Skilled Nursing Facility	2343SNF-13	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386642460
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESERT HEALTH CARE FACILITIES, INC.

Provider Business Mailing Address
First Line	:	272 PIONEER BLVD
Second Line	:
City	:	MESQUITE
State	:	NV
Zip	:	89027
Country	:	US
Telephone Number	:	702-346-7666
Fax Number	:	702-346-7276

Provider Business Practice Location Address
First Line	:	272 PIONEER BLVD
Second Line	:
City	:	MESQUITE
State	:	NV
Zip	:	89027
Country	:	US
Telephone Number	:	702-346-7666
Fax Number	:	702-346-7276

Authorized Official
Title or Position	:	CFO
Name	:	RONALD JAMES WILSON
Credential	:
Telephone Number	:	309-343-1550

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	05/03/2019

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Directions to “DESERT HEALTH CARE FACILITIES, INC. ” Practice Location

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