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General NPI Number Information
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NPI Number | 1356821029
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Entity Type | Organization
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Legal Business Name | SUMMERLIN HEALTHCARE, INC.
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Dates
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Enumeration Date | 08/21/2018
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 350 FALCON RIDGE PKWY, BLDG 200, STE C
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City | MESQUITE
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State | NV
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Zip | 89027-8878
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Country | US
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Telephone | 702-346-4883
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Fax | 702-664-0426
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Provider Business Mailing Address
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Address Line | 350 FALCON RIDGE PKWY STE 204
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City | MESQUITE
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State | NV
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Zip | 89027-8879
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Country | US
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Telephone | 702-346-4883
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Fax | 702-664-0426
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Authorized Official
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Title or Position | TREASURER
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Name | LEE JOHNSON
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Credential |
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Telephone | 208-401-1369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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