Organization
PACIFICA VINTAGE PARK LLC
Active
Other names
Legacies Memory Care At San Martin
Organization subpart
No
Provider details
NPI number
Authorized official
DEEPAK ISRANI (OWNER)
(619) 296-9000
Entity
Organization
Contact information
Practice address
7230 GAGNIER BLVD, LAS VEGAS, NV 89113-4400
(702) 263-6313
Mailing address
7230 GAGNIER BLVD, LAS VEGAS, NV 89113-4400
(702) 263-6313
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
—
—
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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