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General NPI Number Information
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NPI Number | 1427843143
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Entity Type | Individual
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Provider Name | ASSEFA GETACHEW ASEMAHEGN
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Gender | Male
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Dates
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Enumeration Date | 04/12/2025
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Last Update Date | 12/13/2025
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Provider Practice Location Address
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Address Line | 1733 HUNTERS BLUFF DR
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032-7983
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Country | US
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Telephone | 702-824-0019
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Fax | 702-268-8686
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Provider Business Mailing Address
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Address Line | 1733 HUNTERS BLUFF DR
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032-7983
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Country | US
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Telephone | 702-824-0019
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Fax | 702-268-8686
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 11211-AGC-0
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License Number State | NV
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