Organization
DE CRAIG RANCH, LLC
Active
Parent organization
DE CRAIG RANCH, LLC
Other names
Dignity Health-St. Rose Dominican Blue Diamond Campus
Organization subpart
Yes
Provider details
NPI number
Legal business name
DE CRAIG RANCH, LLC
Authorized official
JOHN BUCK (PRESIDENT)
(713) 637-1004
Entity
Organization
Contact information
Practice address
4855 BLUE DIAMOND RD, LAS VEGAS, NV 89139
(713) 637-1146
(281) 298-5311
Mailing address
8686 NEW TRAILS DR, SUITE 100, THE WOODLANDS, TX 77381-1176
(713) 637-1146
(281) 298-5311
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922542968
—
NV
01
—
29-0058
MEDICARE
—
Enumeration date
12/09/2016
Last updated
10/23/2018
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