Organization
DARK KNIGHT TRUST
Active
Other names
Dark Knight OSO Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THERON WARD (CFO/COO)
(702) 754-5701
Entity
Organization
Contact information
Practice address
840 S RANCHO DR, SUITE 4-410, LAS VEGAS, NV 89106-3837
(702) 754-5700
(702) 982-8762
Mailing address
840 S RANCHO DR, SUITE 4-410, LAS VEGAS, NV 89106-3837
(702) 754-5700
(702) 982-8762
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
NV20121035663
NV
246Y00000X
Health Information Specialist/Technologist
—
—
251B00000X
Case Management Agency
Primary
NV20121035663
NV
253Z00000X
In Home Supportive Care Agency
NV20121035663
NV
311Z00000X
Custodial Care Facility
NV20121035663
NV
343900000X
Non-emergency Medical Transport (VAN)
NV20121035663
NV
374U00000X
Home Health Aide
NV20121035663
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NV20121035663
STATE OF NEVADA
NV
Enumeration date
11/18/2013
Last updated
11/18/2013
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