MEDICARE: UTNV LAKES OPERATOR 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1558784686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UTNV LAKES OPERATOR LLC

Provider Business Mailing Address
First Line	:	2620 LAKE SAHARA DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3439
Country	:	US
Telephone Number	:	702-233-9800
Fax Number	:	702-233-8899

Provider Business Practice Location Address
First Line	:	2620 LAKE SAHARA DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3439
Country	:	US
Telephone Number	:	702-233-9800
Fax Number	:	702-233-8899

Authorized Official
Title or Position	:	AUTHORIZED SIGNATORY
Name	:	KENNETH R. ASSIRAN
Credential	:
Telephone Number	:	410-769-5882

Provider Enumeration Date	:	01/24/2014
Last Update Date	:	01/24/2014

Similar Medicare Providers

1194461632 — LAS VEGAS SENIOR LIVING LLC
Practice Location Address:

2620 LAKE SAHARA DR
LAS VEGAS, NV
89117-3439

Practice Phone: 240-457-9148
Practice Fax:

1336081728 — JUSTIN FARLOUGH
Practice Location Address:

4325 N RANCHO DR STE 150
LAS VEGAS, NV
89130-3439

Practice Phone: 833-646-3222
Practice Fax: 833-646-3222

1407798895 — ROSEMARY CASIMIRO
Practice Location Address:

4325 N RANCHO DR STE 150
LAS VEGAS, NV
89130-3439

Practice Phone: 833-646-3222
Practice Fax: 833-646-3222

1396018511 — SUBA PSYCHIATRY PLLC
Practice Location Address:

1530 E SAHARA AVE
LAS VEGAS, NV
89104-3439

Practice Phone: 845-659-6317
Practice Fax: 702-566-4575

1518468073 — ROSA ANGELICA SANDOVAL
Practice Location Address:

4325 N RANCHO DR STE 150
LAS VEGAS, NV
89130-3439

Practice Phone: 702-510-6393
Practice Fax:

1295237584 — RUBY YARITZA HURTADO I
Practice Location Address:

4325 N RANCHO DR STE 150
LAS VEGAS, NV
89130-3439

Practice Phone: 702-820-8891
Practice Fax:

Directions to “UTNV LAKES OPERATOR LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.