Organization
GOOD SHEPHERD REHABILITATIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRENE JOY GOB RN (ADMINISTRATOR)
(702) 380-1060
Entity
Organization
Contact information
Practice address
4275 BURNHAM AVE, SUITE 255, LAS VEGAS, NV 89119-8204
(702) 380-1060
Mailing address
4275 BURNHAM AVE, SUITE 255, LAS VEGAS, NV 89119-8204
(702) 380-1060
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
RC520
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1702161
—
NV
Enumeration date
03/09/2011
Last updated
06/09/2011
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