=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033911920
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DEER SPRINGS ASSISTED LIVING LP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/24/2025
-----------------------------------------------------
Last Update Date | 03/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6741 N DECATUR BLVD BLDG 3
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89131-2721
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-462-7700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9121 W RUSSELL RD STE 219
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89148-1239
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-410-2720
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP OF ASSISTED LIVING
-----------------------------------------------------
Name | MS. CATHY HELTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 702-462-7700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 320700000X
-----------------------------------------------------
Taxonomy Name | Physical Disabilities Residential Treatment Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------