Healthcare Provider Details

I. General information

NPI: 1801607445
Provider Name (Legal Business Name): LAS VEGAS RIDGE HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2025
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 S TORREY PINES DR
LAS VEGAS NV
89146-9051
US

IV. Provider business mailing address

262 N UNIVERSITY AVE
FARMINGTON UT
84025-2975
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax:
Mailing address:
  • Phone: 385-518-1814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ALICIA TORRES-CEPEDA
Title or Position: SENIOR LEGAL/RISK MANAGER
Credential:
Phone: 385-342-5175