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NPI Code Detail

MEDICARE: THI OF NEVADA AT LAS VEGAS I, LLC

MEDICARE: THI OF NEVADA AT LAS VEGAS I, 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

Other Identifiers

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

General Provider Information

NPI Number : 1598852774
Entity Type Code : Organization
Provider Name (Legal Business Name) : THI OF NEVADA AT LAS VEGAS I, LLC
Provider Business Mailing Address
First Line : 920 RIDGEBROOK RD
Second Line :
City : SPARKS
State : MD
Zip : 21152-9390
Country : US
Telephone Number : 410-773-1000
Fax Number :
Provider Business Practice Location Address
First Line : 2170 E HARMON AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-7840
Country : US
Telephone Number : 702-794-0100
Fax Number : 702-794-0041
Authorized Official
Title or Position : PRESIDENT
Name : MELISSA RAY
Credential :
Telephone Number : 702-794-0100
Provider Enumeration Date : 10/07/2006
Last Update Date : 02/26/2013

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