MEDICARE: LAS VEGAS - AMG SPECIALTY HOSPITAL, 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
1	282E00000X	Long Term Care Hospital

General Provider Information

NPI Number	:	1952796617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAS VEGAS - AMG SPECIALTY HOSPITAL, LLC

Provider Business Mailing Address
First Line	:	101 LA RUE FRANCE
Second Line	:	SUITE 100
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-3144
Country	:	US
Telephone Number	:	337-269-9566
Fax Number	:	337-234-1075

Provider Business Practice Location Address
First Line	:	4015 S. MCLEOD DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4305
Country	:	US
Telephone Number	:	702-433-2200
Fax Number	:	702-962-4435

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AUGUST J. RANTZ IV
Credential	:
Telephone Number	:	337-269-9566

Provider Enumeration Date	:	03/31/2015
Last Update Date	:	02/19/2016

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