HENDERSON LONG TERM CARE LLC (NPI# 1811421712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811421712 |
| Entity Type | Organization |
| Organization Name | HENDERSON LONG TERM CARE LLC |
| Other Organization Name | GREEN VALLEY HEALTH AND WELLNESS SUITES |
| Practice Address |
2965 Wigwam Parkway Henderson NV 89074 |
| Mailing Address |
920 Ridgebrook Rd Sparks MD 21152-9390 |
| Practice Telephone | 4107731000 |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2017-04-18 |
| Authorized Official Name | KAM MCGAVOCK (PRESIDENT) |
| Authorized Official Telephone | 4107731000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Green Valley Health and Wellness Suites | Doing Business As Name - Organization |
| Street Address |
2965 WIGWAM PARKWAY |
| City | HENDERSON |
| State | NV |
| Zip Code | 89074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194349381 | Samuel Taylor Mulford | Physical Therapist | 9070 W.cheyenne Ave, Suite 100, Henderson, NV 89074 | 2020-06-03 |
| 1407369127 | Brenda Thomas | Dental Hygienist | 234 Polar Morning Place, Henderson, NV 89074 | 2017-11-16 |
| 1174036479 | Gail E Evans Wade | Behavioral Analyst | 1445 Stone Lake Cove, Henderson, NV 89074 | 2017-11-08 |
| 1710400957 | Kimberley Houk | Behavioral Analyst | 20 Avenida Picasso, Henderson, NV 89074 | 2017-07-19 |
| 1760911846 | Colin Ono-moore | Physical Therapist | 3 Rising Sun Ct, Henderson, NV 89074 | 2017-06-12 |
| 1851825764 | Ralph Wieder | Dietitian, Registered | 1005 Wigwam Pkwy, 23206, Henderson, NV 89074 | 2017-04-18 |
| 1275994642 | Malyna Lavarias | Behavioral Analyst | 74 N Pecos Rd., Suite C, Henderson, NV 89074 | 2016-03-14 |
| 1144608290 | Matthew Roderick | Acupuncturist | 2675 Windmill Pkwy Apt 421, Henderson, NV 89074 | 2015-05-08 |
| 1922494764 | Jennifer Romo Santistevan | Pediatrics | 1505 Wigwam Pkwy Ste 230, Henderson, NV 89074 | 2015-04-08 |
| 1295129559 | Encompass Home Health of The West, LLC | Home Health | 8905 S Pecos Rd Ste 24a, Henderson, NV 89074 | 2015-03-25 |
| Find all providers in zip 89074 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437697430 | Ahc of Henderson LLC | Skilled Nursing Facility | 1285 East Cactus Avenue, Henderson, NV 89183-7714 | 2017-02-09 |
| 1508303090 | Ghc of Henderson LLC | Skilled Nursing Facility | 2855 W Horizon Ridge Pkwy, Henderson, NV 89052 | 2017-01-23 |
| 1699111948 | Advancing Teams Management LLC | Skilled Nursing Facility | 712 Fair Park Dr, Henderson, TX 75654-3208 | 2013-05-14 |
| 1356402515 | Autumn Leaves Nursing and Rehab Inc | Skilled Nursing Facility | 321 Kilgore Dr, Henderson, TX 75652-5215 | 2006-12-12 |
| 1043383771 | Extendicare Homes, Inc. | Skilled Nursing Facility | 2500 N Elm St, Henderson, KY 42420-2005 | 2006-11-17 |
| 1316034598 | Thi of Nevada At Henderson Convalescent LLC | Skilled Nursing Facility | 1180 E Lake Mead Pkwy, Henderson, NV 89015-5561 | 2006-10-07 |
| 1902997356 | Chester Co Healthcare, Inc. | Skilled Nursing Facility | 412 Juanita Dr, Henderson, TN 38340-1949 | 2006-09-28 |
| 1033220348 | Kindred Nursing Centers East, L.L.C. | Skilled Nursing Facility | 280 S Beckford Dr, Henderson, NC 27536-2564 | 2006-08-31 |
| 1972547321 | Eagle Peak Ltc Group, LLC | Skilled Nursing Facility | 1245 Park Ave, Henderson, NC 27536-4025 | 2006-06-16 |
| 1922065655 | Nexion Health At Southwood Inc | Skilled Nursing Facility | 701 Fair Park Dr, Henderson, TX 75654-3207 | 2006-04-27 |
| Find all providers in HENDERSON | ||||
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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.