MEDICARE: ROSS SENIOR RESIDENCE

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	251J00000X	Nursing Care Agency	NVS2175AGC	NV

General Provider Information

NPI Number	:	1740776871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSS SENIOR RESIDENCE

Provider Business Mailing Address
First Line	:	5935 W SADDLE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-0118
Country	:	US
Telephone Number	:	702-365-6124
Fax Number	:

Provider Business Practice Location Address
First Line	:	5935 W SADDLE AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-0118
Country	:	US
Telephone Number	:	702-365-6124
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CRISTI C ROSS
Credential	:
Telephone Number	:	702-580-3879

Provider Enumeration Date	:	07/01/2018
Last Update Date	:	07/01/2018

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Directions to “ROSS SENIOR RESIDENCE ” Practice Location

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