Healthcare Provider Details

I. General information

NPI: 1003110933
Provider Name (Legal Business Name): ARV NEVADA ASSISTED LIVING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2011
Last Update Date: 01/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3185 E FLAMINGO RD
LAS VEGAS NV
89121-4386
US

IV. Provider business mailing address

3185 E FLAMINGO RD
LAS VEGAS NV
89121-4386
US

V. Phone/Fax

Practice location:
  • Phone: 702-436-9000
  • Fax:
Mailing address:
  • Phone: 702-436-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JOHN MOORE
Title or Position: CEO
Credential:
Phone: 502-779-7608