Healthcare Provider Details

I. General information

NPI: 1639494867
Provider Name (Legal Business Name): CENTER FOR COMPASSIONATE CARE AND PALLIATIVE SERVICES INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2010
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4131 UNIVERSITY CENTER DR
LAS VEGAS NV
89119-6718
US

IV. Provider business mailing address

4131 UNIVERSITY CENTER DR
LAS VEGAS NV
89119-6718
US

V. Phone/Fax

Practice location:
  • Phone: 702-733-0320
  • Fax: 702-796-3152
Mailing address:
  • Phone: 702-733-0320
  • Fax: 702-796-3152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LH0002X
TaxonomyHospice and Palliative Medicine (Anesthesiology) Physician
License Number20090616100099350
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN RUBEL
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 702-796-3112