EDUCARE COMMUNITY LIVING CORPORATION - NEVADA (NPI# 1003425133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003425133 |
| Entity Type | Organization |
| Organization Name | EDUCARE COMMUNITY LIVING CORPORATION - NEVADA |
| Practice Address |
2258 Bridlewood Dr Las Vegas NV 89119-6121 |
| Mailing Address |
805 N Whittington Pkwy Louisville KY 40222-7101 |
| Practice Telephone | 5023942100 |
| Mailing Telephone | 5026307249 |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2020-07-24 |
| Authorized Official Name | MR. TIMOTHY TYLER WHOBREY (PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 5026307249 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295344430 | Educare Community Living Corporation - Nevada | Intermediate Care Facility, Mentally Retarded | 4575 W Capovilla Ave, Las Vegas, NV 89118-5044 | 2020-07-23 |
| 1982808200 | Educare Community Living Corporation - Nevada | Intermediate Care Facility, Mentally Retarded | 2025 Houston Dr, Las Vegas, NV 89104-2009 | 2007-06-12 |
| 1073717393 | Educare Community Living Corporation - Nevada | Intermediate Care Facility, Mentally Retarded | 3829 Tumbleweed Ave, Las Vegas, NV 89121-4541 | 2007-06-12 |
| 1083817605 | Educare Community Living Corporation - Nevada | Intermediate Care Facility, Mentally Retarded | 54 E Ford Ave, Las Vegas, NV 89123-1667 | 2007-06-10 |
| 1659720019 | Educare Community Living Corporation - Nevada | Intermediate Care Facility, Mentally Retarded | 7095 Cameron St, Las Vegas, NV 89118-5018 | 2016-06-07 |
| 1033447859 | Educare Community Living Corporation - Nevada | Community/Behavioral Health | 3811 W Charleston Blvd, Suite 210, Las Vegas, NV 89102-1846 | 2009-12-07 |
| 1427252741 | Educare Community Living Corporation - Nevada | Intermediate Care Facility, Mentally Retarded | 3811 W Charleston Blvd, Suite 210, Las Vegas, NV 89102-1846 | 2007-06-12 |
| 1063616381 | Educare Community Living Corporation - Nevada | Intermediate Care Facility, Mentally Retarded | 3811 W Charleston Blvd, Suite 210, Las Vegas, NV 89102-1846 | 2007-06-12 |
| Street Address |
2258 BRIDLEWOOD DR |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89119-6121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669089298 | Jennifer Chavon Cruse | Technician | [email protected], 1775 East Tropicana Avenue 16-b, Las Vegas, NV 89119 | 2020-09-28 |
| 1063024214 | Rosa Isela Martinez Gonzalez | Technician | 4324 S. Eastern Ave. Ste. B, Las Vegas, NV 89119 | 2020-08-19 |
| 1720697980 | Christian Scott | Social Worker | 4055 Spencer St #118, Las Vegas, NV 89119 | 2020-07-23 |
| 1245867159 | Starfruit Holdings, LLC | Skilled Nursing Facility | 4375 S Eastern Ave, Paradise, NV 89119 | 2020-03-23 |
| 1215562376 | Phyllis Eberechukwu Hunt | Adult Companion | 5160 Tamarus St Appt 17, Las Vegas, NV 89119 | 2020-03-10 |
| 1841832581 | Legna Carrillo | Adult Companion | 4325 South Bruce St Appt 63, Las Vegas, NV 89119 | 2019-10-15 |
| 1104468339 | Alma Leticia Salazar | Home Health Aide | Safe At Home, LLC, 1775 E. Tropicana Ave. Suit 16-b, Las Vegas, NV 89119 | 2019-10-09 |
| 1083260046 | Araceli Rosas Vargas | Technician | 5160 S. Eastern Ave, Suite E, Las Vegas, NV 89119 | 2019-08-15 |
| 1376197707 | Bristure Clayton | Technician | Safe At Home LLC, 1775 E Tropicana Ave Ste 16, Las Vegas, NV 89119 | 2019-07-24 |
| 1457904534 | Carmen Laura Gonzalez Valenzuela | Chore Provider | 6725-1 S. Eastern Ave, Las Vegas, NV 89119 | 2019-07-18 |
| Find all providers in zip 89119 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295344430 | Educare Community Living Corporation - Nevada | Intermediate Care Facility, Mentally Retarded | 4575 W Capovilla Ave, Las Vegas, NV 89118-5044 | 2020-07-23 |
| 1578124939 | Centers for Neurobehavioral Excellence | Intermediate Care Facility, Mentally Retarded | 2209 Barchetta Dr, Las Vegas, NV 89134-6028 | 2019-06-26 |
| 1134677735 | Pamela Turner | Intermediate Care Facility, Mentally Retarded | 5831 Delonee Skies Ave, Las Vegas, NV 89131-2087 | 2016-09-13 |
| 1982808200 | Educare Community Living Corporation - Nevada | Intermediate Care Facility, Mentally Retarded | 2025 Houston Dr, Las Vegas, NV 89104-2009 | 2007-06-12 |
| 1073717393 | Educare Community Living Corporation - Nevada | Intermediate Care Facility, Mentally Retarded | 3829 Tumbleweed Ave, Las Vegas, NV 89121-4541 | 2007-06-12 |
| 1083817605 | Educare Community Living Corporation - Nevada | Intermediate Care Facility, Mentally Retarded | 54 E Ford Ave, Las Vegas, NV 89123-1667 | 2007-06-10 |
| 1811043912 | Danville Services of Nevada, LLC | Intermediate Care Facility, Mentally Retarded | 7095 Cameron St, Las Vegas, NV 89118-5018 | 2007-01-25 |
| 1669528576 | Danville Services of Nevada, LLC | Intermediate Care Facility, Mentally Retarded | 3640 Citadel Cir, Las Vegas, NV 89118-5215 | 2007-01-25 |
| 1962558072 | Danville Services of Nevada, LLC | Intermediate Care Facility, Mentally Retarded | 115 E Shelbourne Ave, Las Vegas, NV 89123-2163 | 2007-01-25 |
| 1659720019 | Educare Community Living Corporation - Nevada | Intermediate Care Facility, Mentally Retarded | 7095 Cameron St, Las Vegas, NV 89118-5018 | 2016-06-07 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.