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General NPI Number Information
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NPI Number | 1194461632
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Entity Type | Organization
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Legal Business Name | LAS VEGAS SENIOR LIVING LLC
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 2620 LAKE SAHARA DR
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City | LAS VEGAS
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State | NV
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Zip | 89117-3439
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Country | US
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Telephone | 240-457-9148
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Fax |
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Provider Business Mailing Address
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Address Line | 12377 MERIT DR STE 500
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City | DALLAS
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State | TX
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Zip | 75251-2343
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ASSISTANT CONTROLLER
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Name | AMBER ASHFORD
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Credential |
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Telephone | 214-572-9459
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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