MEDICARE: NEVADA HABILITATION CENTER

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	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1457122467
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEVADA HABILITATION CENTER

Provider Business Mailing Address
First Line	:	3365 WYNN RD STE F
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8202
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2920 S RAINBOW BLVD STE 130
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6214
Country	:	US
Telephone Number	:	702-209-3595
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MORGAN RODRIGUEZ
Credential	:
Telephone Number	:	702-209-3595

Provider Enumeration Date	:	01/10/2024
Last Update Date	:	01/10/2024

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Directions to “NEVADA HABILITATION CENTER ” Practice Location

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