Healthcare Provider Details

I. General information

NPI: 1922821859
Provider Name (Legal Business Name): TAPD MEDICAL AND TREE HOUSE ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 FALLEN TREE CT
HENDERSON NV
89074-6299
US

IV. Provider business mailing address

42 FALLEN TREE CT
HENDERSON NV
89074-6299
US

V. Phone/Fax

Practice location:
  • Phone: 702-826-6760
  • Fax:
Mailing address:
  • Phone: 702-826-6760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. THERESA WALKER
Title or Position: OWNER
Credential: APRN-C
Phone: 702-826-6760