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NPI Code Detail

MEDICARE: LB REGENCY PLAZA LLC

MEDICARE: LB REGENCY PLAZA 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
1310400000XAssisted Living Facility2089AGC-9NV

General Provider Information

NPI Number : 1881686855
Entity Type Code : Organization
Provider Name (Legal Business Name) : LB REGENCY PLAZA LLC
Provider Business Mailing Address
First Line : 6031 W CHEYENNE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-4200
Country : US
Telephone Number : 702-658-5882
Fax Number : 702-658-5842
Provider Business Practice Location Address
First Line : 6031 W CHEYENNE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-4200
Country : US
Telephone Number : 702-658-5882
Fax Number : 702-658-5842
Authorized Official
Title or Position : CEO/PRESIDENT
Name : JOSEPH C TUTERA
Credential :
Telephone Number : 816-444-0900
Provider Enumeration Date : 08/16/2005
Last Update Date : 08/22/2020

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Directions to “LB REGENCY PLAZA LLC ” Practice Location

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