Healthcare Provider Details

I. General information

NPI: 1952796617
Provider Name (Legal Business Name): LAS VEGAS - AMG SPECIALTY HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2015
Last Update Date: 02/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4015 S. MCLEOD DR
LAS VEGAS NV
89121-4305
US

IV. Provider business mailing address

101 LA RUE FRANCE SUITE 100
LAFAYETTE LA
70508-3144
US

V. Phone/Fax

Practice location:
  • Phone: 702-433-2200
  • Fax: 702-962-4435
Mailing address:
  • Phone: 337-269-9566
  • Fax: 337-234-1075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: AUGUST J. RANTZ IV
Title or Position: PRESIDENT
Credential:
Phone: 337-269-9566