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General NPI Number Information
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NPI Number | 1285450676
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Entity Type | Organization
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Legal Business Name | HENDERSON CORONADO NV OPCO LLC
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 2855 W HORIZON RIDGE PKWY
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City | HENDERSON
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State | NV
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Zip | 89052-4394
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Country | US
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Telephone | 702-805-5050
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Fax |
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Provider Business Mailing Address
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Address Line | 229 ROUTE 70 STE 205
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City | TOMS RIVER
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State | NJ
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Zip | 08755-1026
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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 | VP OPERATIONS
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Name | AHARON FRANCO
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Credential |
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Telephone | 646-823-6464
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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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