# DEPARTMENT OF VETERANS AFFAIRS

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

## Provider details

- **NPI number:** 1659545648
- **Authorized official:** VERNON MANIAGO RN (REGISTERED NURSE)
- **Authorized official phone:** (702) 677-1077

## Contact information

- **Practice address:** 5555 BAKER BOWL CT, LAS VEGAS, NV 89148-4630
- **Practice address phone:** (702) 653-3633
- **Mailing address:** 5555 BAKER BOWL CT, LAS VEGAS, NV 89148-4630

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | RN53305 | NV | Yes |

## Other

- **Enumeration date:** 04/22/2008
- **Last updated:** 04/22/2008