Spruce Oak Residential Care Facility
Assisted Living Facility, Assisted Living, Mental Illness in North Las Vegas, NV. Organization (NPI-2).
NPI number1164825022
StatusActive
Last updated in NPPESNov 25, 2014
Details
- NPI
- 1164825022
- Entity type
- Organization (NPI-2)
- Legal business name
- Spruce Oak Residential Care Facility
- Organization subpart
- No
- Enumeration date
- Oct 6, 2014
- Last updated
- Nov 25, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3104A0625X | Assisted Living Facility, Assisted Living, Mental Illness | 5954AGC-10 | NV | Yes |
Practice location
4618 Spruce Oak DrNorth Las Vegas, NV 89031-0179
Phone 702-462-2031
Mailing address
4618 Spruce Oak DrNorth Las Vegas, NV 89031-0179
Phone 702-462-2031
Authorized official
Melissa St Jean
Manager
7022359644
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