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Organization

SPRUCE OAK RESIDENTIAL CARE FACILITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELISSA ST JEAN (MANAGER)
(702) 235-9644
Entity
Organization

Contact information

Practice address
4618 SPRUCE OAK DR, NORTH LAS VEGAS, NV 89031-0179
(702) 462-2031
Mailing address
4618 SPRUCE OAK DR, NORTH LAS VEGAS, NV 89031-0179
(702) 462-2031

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
5954AGC-10
NV

Other

Enumeration date
10/06/2014
Last updated
11/25/2014
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