Healthcare Provider Details

I. General information

NPI: 1457620973
Provider Name (Legal Business Name): SPRINGS VALLEY ASSISTED LIVING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2011
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6650 W FLAMINGO RD
LAS VEGAS NV
89103-2142
US

IV. Provider business mailing address

6650 W FLAMINGO RD
LAS VEGAS NV
89103-2142
US

V. Phone/Fax

Practice location:
  • Phone: 702-732-2800
  • Fax: 702-873-5316
Mailing address:
  • Phone: 702-732-2800
  • Fax: 702-873-5316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number410AGC-32
License Number StateNV

VIII. Authorized Official

Name: AMBER L TUELLER
Title or Position: SECRETARY
Credential:
Phone: 208-207-2726