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NPI Code Detail

MEDICARE: EDUCARE COMMUNITY LIVING CORP

MEDICARE: EDUCARE COMMUNITY LIVING CORP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310500000XMental Illness Intermediate Care FacilityNV

General Provider Information

NPI Number : 1063473460
Entity Type Code : Organization
Provider Name (Legal Business Name) : EDUCARE COMMUNITY LIVING CORP
Provider Business Mailing Address
First Line : 3811 W CHARLESTON BLVD
Second Line : 210
City : LAS VEGAS
State : NV
Zip : 89102-1846
Country : US
Telephone Number : 702-880-0961
Fax Number : 702-880-0965
Provider Business Practice Location Address
First Line : 3811 W CHARLESTON BLVD
Second Line : 210
City : LAS VEGAS
State : NV
Zip : 89102-1846
Country : US
Telephone Number : 702-880-0961
Fax Number : 702-880-0965
Authorized Official
Title or Position : REGIONAL V.P.
Name : DAVE RHODES
Credential :
Telephone Number : 303-702-0056
Provider Enumeration Date : 03/28/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

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1457512923 — DR. GARY DEE GOASLIND D.D.S., M.S.
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1295996627 — DR. RYAN SCOTT GIFFORD D.D.S.
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Directions to “EDUCARE COMMUNITY LIVING CORP ” Practice Location

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