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NPI Code Detail

MEDICARE: LAS VEGAS OPERATIONS, LLC

MEDICARE: LAS VEGAS OPERATIONS, 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 Facility

General Provider Information

NPI Number : 1891269759
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAS VEGAS OPERATIONS, LLC
Provider Business Mailing Address
First Line : 25117 SW PARKWAY AVE STE F
Second Line :
City : WILSONVILLE
State : OR
Zip : 97070-9697
Country : US
Telephone Number :
Fax Number :
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 :
Authorized Official
Title or Position : CEO
Name : KARL MILLER JR.
Credential :
Telephone Number : 503-570-3405
Provider Enumeration Date : 01/14/2019
Last Update Date : 01/14/2019

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Directions to “LAS VEGAS OPERATIONS, LLC ” Practice Location

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