Healthcare Provider Details

I. General information

NPI: 1073381661
Provider Name (Legal Business Name): STROKE SOLUTIONS REHABILITATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 12/13/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5415 W HARMON AVE
LAS VEGAS NV
89103-5098
US

IV. Provider business mailing address

304 S JONES BLVD STE 950
LAS VEGAS NV
89107-2623
US

V. Phone/Fax

Practice location:
  • Phone: 775-513-7013
  • Fax:
Mailing address:
  • Phone: 775-513-7013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. CRAIG CHANG
Title or Position: MANAGER
Credential: OT
Phone: 775-513-7013