Healthcare Provider Details

I. General information

NPI: 1043474232
Provider Name (Legal Business Name): REM NEVADA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2008
Last Update Date: 04/22/2023
Certification Date: 04/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5693 SOUTH JONES
LAS VEGAS NV
89118
US

IV. Provider business mailing address

5693 SOUTH JONES
LAS VEGAS NV
89118
US

V. Phone/Fax

Practice location:
  • Phone: 702-889-9240
  • Fax: 702-889-6945
Mailing address:
  • Phone: 702-889-9240
  • Fax: 702-889-6945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: BRETT IAN COHEN
Title or Position: COO
Credential:
Phone: 800-388-5150