# TIMELESS INDIVIDUAL RESIDENTIAL CARE

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

## Provider details

- **NPI number:** 1942665922
- **Authorized official:** MRS. CARRIE SANDERS TROUTMAN (DIRECTOR)
- **Authorized official phone:** (702) 395-5834

## Contact information

- **Practice address:** 4617 SANTA MONICA AVE, NORTH LAS VEGAS, NV 89032-2831
- **Practice address phone:** (702) 395-5834
- **Practice address fax:** (702) 645-1020
- **Mailing address:** 4617 SANTA MONICA AVE, NORTH LAS VEGAS, NV 89032-2831
- **Mailing address phone:** (702) 395-5834
- **Mailing address fax:** (702) 645-1020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 4279HIC-9 | NV | Yes |

## Other

- **Enumeration date:** 12/17/2015
- **Last updated:** 12/17/2015