MEDICARE: TRANSITIONAL HOSPITALS CORPORATION OF 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	282E00000X	Long Term Care Hospital	664HOS-18	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	292002	OTHER	NV	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366520884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSITIONAL HOSPITALS CORPORATION OF NEVADA LLC

Provider Business Mailing Address
First Line	:	5110 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3406
Country	:	US
Telephone Number	:	702-871-1418
Fax Number	:	702-871-4713

Provider Business Practice Location Address
First Line	:	5110 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146
Country	:	US
Telephone Number	:	702-871-1418
Fax Number	:	702-871-4713

Authorized Official
Title or Position	:	VICE PRESIDENT, CORPORATE SECRETARY
Name	:	KATHY TEAGUE
Credential	:
Telephone Number	:	629-253-5121

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	03/21/2022

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