Organization
SPRING MOUNTAIN REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ARLYNE SALONGA MICIANO (PRESIDENT/OWNER)
(702) 869-4401
Entity
Organization
Contact information
Practice address
7730 W CHEYENNE AVE STE 105, LAS VEGAS, NV 89129-8411
(702) 869-4401
(702) 869-9904
Mailing address
5155 S DURANGO DR STE 101, LAS VEGAS, NV 89113-0174
(702) 869-4401
(702) 869-9904
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
294504
NV
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001702162
—
NV
Enumeration date
07/05/2005
Last updated
06/29/2023
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