MEDICARE: ATRIUM NEVADA, LLC

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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1285257691
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATRIUM NEVADA, LLC

Provider Business Mailing Address
First Line	:	8490 S EASTERN AVE STE B1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2806
Country	:	US
Telephone Number	:	702-676-1130
Fax Number	:	702-895-9992

Provider Business Practice Location Address
First Line	:	8490 S EASTERN AVE STE B1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2806
Country	:	US
Telephone Number	:	702-676-1130
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	JANYVILL RUIZ
Credential	:
Telephone Number	:	702-301-8862

Provider Enumeration Date	:	05/20/2020
Last Update Date	:	05/08/2024

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