Organization
THI OF NEVADA II AT DESERT LANE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRIN COOK (PRESIDENT)
(702) 565-8555
Entity
Organization
Contact information
Practice address
640 S MARTIN L KING BLVD, LAS VEGAS, NV 89106-4413
(702) 382-3155
(702) 384-5659
Mailing address
920 RIDGEBROOK RD, SPARKS, MD 21152-9390
(410) 773-1000
Taxonomy
Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5602006
—
NV
Enumeration date
10/11/2006
Last updated
07/25/2019
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