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General NPI Number Information
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NPI Number | 1144057100
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Entity Type | Organization
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Legal Business Name | DESERT BLOOM SKILLED CARE LLC
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Dates
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Enumeration Date | 09/16/2024
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 6070 W POST RD
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City | LAS VEGAS
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State | NV
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Zip | 89118-3419
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Country | US
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Telephone | 775-293-2312
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Fax |
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Provider Business Mailing Address
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Address Line | 6492 MOUNT EDEN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89139-7212
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Country | US
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Telephone | 775-293-2312
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | HEATHER ROWLEY
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Credential | LNHA
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Telephone | 775-293-2312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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