# GREEN VALLEY SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487187076
- **Authorized official:** AMY GRIM (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (702) 202-4776

## Contact information

- **Practice address:** 7365 S PECOS RD, LAS VEGAS, NV 89120-3768
- **Practice address phone:** (702) 857-6500
- **Practice address fax:** (702) 857-6501
- **Mailing address:** 50 S STEPHANIE ST STE 101, HENDERSON, NV 89012-5731
- **Mailing address phone:** (702) 202-4776
- **Mailing address fax:** (702) 202-6110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/10/2017
- **Last updated:** 03/29/2023