MEDICARE: OAKEY ASSISTED LIVING

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	311500000X	Alzheimer Center (Dementia Center)

General Provider Information

NPI Number	:	1770317612
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAKEY ASSISTED LIVING

Provider Business Mailing Address
First Line	:	3900 W OAKEY BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-0544
Country	:	US
Telephone Number	:	702-343-1859
Fax Number	:

Provider Business Practice Location Address
First Line	:	3900 W OAKEY BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-0544
Country	:	US
Telephone Number	:	702-343-1859
Fax Number	:

Authorized Official
Title or Position	:	GM
Name	:	MR. PHILIP PRENTISS
Credential	:
Telephone Number	:	702-343-1859

Provider Enumeration Date	:	08/30/2024
Last Update Date	:	09/25/2024

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Directions to “OAKEY ASSISTED LIVING ” Practice Location

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