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NPI Code Detail

MEDICARE: SPRING MOUNTAIN REHAB, LLC

MEDICARE: SPRING MOUNTAIN REHAB, 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
1261QR0401XComprehensive Outpatient Rehabilitation Facility (CORF)
2261QR0401XComprehensive Outpatient Rehabilitation Facility (CORF)294504NV

Other Identifiers

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

General Provider Information

NPI Number : 1447257456
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPRING MOUNTAIN REHAB, LLC
Provider Business Mailing Address
First Line : 5155 S DURANGO DR STE 101
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-0174
Country : US
Telephone Number : 702-869-4401
Fax Number : 702-869-9904
Provider Business Practice Location Address
First Line : 7730 W CHEYENNE AVE STE 105
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-8411
Country : US
Telephone Number : 702-869-4401
Fax Number : 702-869-9904
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : MS. ARLYNE SALONGA MICIANO
Credential :
Telephone Number : 702-869-4401
Provider Enumeration Date : 07/05/2005
Last Update Date : 06/29/2023

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Directions to “SPRING MOUNTAIN REHAB, LLC ” Practice Location

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