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NPI Code Detail

MEDICARE: CHATEAU AMORE, LLC

MEDICARE: CHATEAU AMORE, 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
1311ZA0620XAdult Care Home Facility8453-AGC-0NV

General Provider Information

NPI Number : 1780034751
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHATEAU AMORE, LLC
Provider Business Mailing Address
First Line : 7830 SPENCER ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-2025
Country : US
Telephone Number : 702-203-3009
Fax Number :
Provider Business Practice Location Address
First Line : 7830 SPENCER ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-2025
Country : US
Telephone Number : 702-203-3009
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : CHRISTINA SMITH
Credential : ADMINISTRATOR, MSW
Telephone Number : 702-203-3009
Provider Enumeration Date : 06/21/2016
Last Update Date : 06/21/2016

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Directions to “CHATEAU AMORE, LLC ” Practice Location

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