Healthcare Provider Details

I. General information

NPI: 1790785590
Provider Name (Legal Business Name): MARQUIS COMPANIES I, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 07/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6021 W CHEYENNE AVE
LAS VEGAS NV
89108-4205
US

IV. Provider business mailing address

6021 W CHEYENNE AVE
LAS VEGAS NV
89108-4205
US

V. Phone/Fax

Practice location:
  • Phone: 702-658-9494
  • Fax: 702-658-9419
Mailing address:
  • Phone: 702-658-9494
  • Fax: 702-658-9419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2097SNF-5
License Number StateNV

VIII. Authorized Official

Name: STACI L TONE
Title or Position: CORPORATE CONTROLLER
Credential:
Phone: 971-206-5125