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NPI Code Detail

MEDICARE: COURAGE COTTAGE,L.L.C

MEDICARE: COURAGE COTTAGE,L.L.C
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
1174200000XMeals Provider
2177F00000XLodging Provider
3251K00000XPublic Health or Welfare Agency
4261QP0905XState or Local Public Health Clinic/Center
53104A0625XAssisted Living Facility (Mental Illness)
6320800000XMental Illness Community Based Residential Treatment Facility
7347C00000XPrivate Vehicle
8374U00000XHome Health Aide
9320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number : 1780338681
Entity Type Code : Organization
Provider Name (Legal Business Name) : COURAGE COTTAGE,L.L.C
Provider Business Mailing Address
First Line : 4233 HEBRON DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-4943
Country : US
Telephone Number : 702-354-2269
Fax Number :
Provider Business Practice Location Address
First Line : 4233 HEBRON DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-4943
Country : US
Telephone Number : 702-354-2269
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DENISE JONES
Credential :
Telephone Number : 702-354-2269
Provider Enumeration Date : 02/09/2022
Last Update Date : 02/09/2022

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Directions to “COURAGE COTTAGE,L.L.C ” Practice Location

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