MEDICARE: DESERT HEALTH CARE FACILITIES, INC

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
1	314000000X	Skilled Nursing Facility	4202SNF8	NV
2	314000000X	Skilled Nursing Facility	4202SNF-8	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093701856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESERT HEALTH CARE FACILITIES, INC

Provider Business Mailing Address
First Line	:	550 N SHERMAN
Second Line	:
City	:	FALLON
State	:	NV
Zip	:	89406
Country	:	US
Telephone Number	:	775-423-7800
Fax Number	:	775-423-7845

Provider Business Practice Location Address
First Line	:	550 N SHERMAN
Second Line	:
City	:	FALLON
State	:	NV
Zip	:	89406
Country	:	US
Telephone Number	:	775-423-7800
Fax Number	:	775-423-7845

Authorized Official
Title or Position	:	C.F.O.
Name	:	MR. RONALD J WILSON
Credential	:
Telephone Number	:	309-343-1550

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	01/07/2014

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