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General NPI Number Information
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NPI Number | 1003246612
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Entity Type | Organization
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Legal Business Name | DARK KNIGHT TRUST
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Dates
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Enumeration Date | 11/18/2013
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Last Update Date | 11/18/2013
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Provider Practice Location Address
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Address Line | 840 S RANCHO DR SUITE 4-410
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City | LAS VEGAS
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State | NV
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Zip | 89106-3837
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Country | US
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Telephone | 702-754-5700
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Fax | 702-982-8762
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Provider Business Mailing Address
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Address Line | 840 S RANCHO DR SUITE 4-410
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City | LAS VEGAS
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State | NV
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Zip | 89106-3837
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Country | US
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Telephone | 702-754-5700
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Fax | 702-982-8762
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Authorized Official
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Title or Position | CFO/COO
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Name | MR. THERON WARD
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Credential |
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Telephone | 702-754-5701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | NV20121035663
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 246Y00000X
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Taxonomy Name | Health Information Specialist/Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | NV20121035663
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number | NV20121035663
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License Number State | NV
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Taxonomy #5
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | NV20121035663
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License Number State | NV
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Taxonomy #6
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | NV20121035663
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License Number State | NV
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Taxonomy #7
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | NV20121035663
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License Number State | NV
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