Healthcare Provider Details

I. General information

NPI: 1548437965
Provider Name (Legal Business Name): SALVATION ARMY HENDERSON ADULT DAY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2008
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 E LAKE MEAD PKWY
HENDERSON NV
89015-5512
US

IV. Provider business mailing address

830 E LAKE MEAD PKWY
HENDERSON NV
89015-5512
US

V. Phone/Fax

Practice location:
  • Phone: 702-565-8836
  • Fax: 702-558-8277
Mailing address:
  • Phone: 702-565-8836
  • Fax: 702-558-8277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MISS SHARON DELOIS EVANS
Title or Position: DIRECTOR
Credential: BS, QMRP
Phone: 702-565-8836