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NPI Code Detail

MEDICARE: DESERT INN RESIDENTIAL CARE

MEDICARE: DESERT INN RESIDENTIAL CARE
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 Facility3119AGZ-13NV

General Provider Information

NPI Number : 1992256143
Entity Type Code : Organization
Provider Name (Legal Business Name) : DESERT INN RESIDENTIAL CARE
Provider Business Mailing Address
First Line : 7160 DARBY AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-3122
Country : US
Telephone Number : 702-203-3450
Fax Number : 702-252-5092
Provider Business Practice Location Address
First Line : 2845 BURNHAM AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-1793
Country : US
Telephone Number : 702-203-3450
Fax Number : 702-252-5092
Authorized Official
Title or Position : ADMINISTRATOR
Name : JASMINE CASTILLO
Credential :
Telephone Number : 702-203-3450
Provider Enumeration Date : 10/21/2016
Last Update Date : 10/21/2016

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Directions to “DESERT INN RESIDENTIAL CARE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.