EDUCARE COMMUNITY LIVING CORPORATION - NEVADA (NPI# 1073717393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073717393 |
| Entity Type | Organization |
| Organization Name | EDUCARE COMMUNITY LIVING CORPORATION - NEVADA |
| Practice Address |
3829 Tumbleweed Ave Las Vegas NV 89121-4541 |
| Mailing Address |
805 N Whittington Pkwy Louisville KY 40222-5186 |
| Practice Telephone | 5023942100 |
| Mailing Telephone | 5023942100 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2019-07-17 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | 001602015 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003425133 | Educare Community Living Corporation - Nevada | Intermediate Care Facility, Mentally Retarded | 2258 Bridlewood Dr, Las Vegas, NV 89119-6121 | 2020-07-24 |
| 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 |
| 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 |
3829 TUMBLEWEED AVE |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89121-4541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598379117 | Western State Behavioral Health and Psychiatric Services | Psychologist | 3910 Pecos-mcleod Interconnect, Las Vegas, NV 89121 | 2020-09-01 |
| 1962025155 | Arieste Diaz Perez | Clinic/Center | 3777 Pecos-mcleod Interconnect, Suite 101, Las Vegas, NV 89121 | 2020-05-21 |
| 1366071904 | Vanesa Silva | Behavior Technician | 4714 Flamigo Rd, Las Vegas, NV 89121 | 2020-04-06 |
| 1053955732 | Valente Solis Santiago | Technician | 2785 E. Desert Inn Rd Ste. 240, Las Vegas, NV 89121 | 2019-11-05 |
| 1750938981 | Ken Ernst | Rehabilitation Practitioner | Primary Solutions Medical Billing, 4525 S. Sandhill Rd Ste #112, Las Vegas, NV 89121 | 2019-08-22 |
| 1902450455 | Tracey Anora Henry | Counselor | 3675 Pecos Mecleod Ste 900, Las Vegas, NV 89121 | 2019-08-01 |
| 1679127096 | Wilma Guadalupe Nunez | Chore Provider | 2860 East Flamingo, Suite C, Las Vegas, NV 89121 | 2019-07-25 |
| 1487213807 | Karla Susana Ayala | Chore Provider | 2860 E. Flamingo Rd Ste K., Las Vegas, NV 89121 | 2019-06-10 |
| 1447819164 | Jovita Garcia-perez | Chore Provider | 2860 E. Flamingo Suite C, Suite C, Las Vegas, NV 89121 | 2019-06-06 |
| 1164081972 | Maria Isabel Castellanos Gonzalez | Chore Provider | 2860 E. Flamingo Rd Ste K, Las Vegas, NV 89121 | 2019-06-06 |
| Find all providers in zip 89121 | ||||
| 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 |
|---|---|---|---|---|
| 1003425133 | Educare Community Living Corporation - Nevada | Intermediate Care Facility, Mentally Retarded | 2258 Bridlewood Dr, Las Vegas, NV 89119-6121 | 2020-07-24 |
| 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 |
| 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 | ||||
Please comment or provide details below to improve the information on EDUCARE COMMUNITY LIVING CORPORATION - NEVADA.
| 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.