{
"Npi": {
"NPI": "1801607445",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LAS VEGAS RIDGE HEALTHCARE, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "262 N UNIVERSITY AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FARMINGTON",
"MailingAddressStateName": "UT",
"MailingAddressPostalCode": "84025-2975",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "385-518-1814",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1151 S TORREY PINES DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAS VEGAS",
"PracticeLocationAddressStateName": "NV",
"PracticeLocationAddressPostalCode": "89146-9051",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "--",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/14/2025",
"LastUpdateDate": "05/29/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TORRES-CEPEDA",
"AuthorizedOfficialFirstName": "ALICIA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SENIOR LEGAL/RISK MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "385-342-5175",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}