Healthcare Provider Details

I. General information

NPI: 1508303090
Provider Name (Legal Business Name): GHC OF HENDERSON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2017
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 W HORIZON RIDGE PKWY
HENDERSON NV
89052
US

IV. Provider business mailing address

2855 W HORIZON RIDGE PKWY
HENDERSON NV
89052-4394
US

V. Phone/Fax

Practice location:
  • Phone: 702-805-5050
  • Fax:
Mailing address:
  • Phone: 702-805-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: THOMAS E OLDS JR.
Title or Position: PRESIDENT
Credential:
Phone: 714-241-5600