Organization
CHARLESTON PEDIATRIC SNF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL EVANS MATHIS (CEO)
(702) 310-3720
Entity
Organization
Contact information
Practice address
2496 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2179
(702) 310-3720
(702) 310-3722
Mailing address
2496 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2179
(702) 310-3720
(702) 310-3722
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
08/30/2021
Last updated
02/13/2025
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