NPIMap

Organization Active NPI

Educare Community Living Corporation - Nevada

  • Intellectual Disabilities Intermediate Care Facility
  • Las Vegas, NV
National Provider Identifier
1295344430
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
EDUCARE COMMUNITY LIVING CORPORATION - NEVADA
Practice address
4575 W Capovilla Ave
Las Vegas, NV 89118-5044
Phone
(702) 880-0961
NPI assigned
Jul 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary Patricia Rodenberg-Roberts
Title
VP & Sr Asst General Counsel
Phone
(952) 836-2234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

4575 W Capovilla Ave
Las Vegas, NV 89118-5044

Mailing address

6600 France Ave S Ste 350
Edina, MN 55435-1810
Phone (800) 388-5150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 29G030

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
EDUCARE-CAPOVILLA
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Apr 8, 2021
Last certification
Apr 24, 2025
Beds
6
Ownership / control type
Private (proprietary)
Facility address
4575 W Capovilla Ave
Las Vegas, NV 89118

National Provider Directory

National Provider Directory
Tax ID family
Educare Community Living Corporation - Nevada11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1295344430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S STE 350",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351810",
            "telephone_number": "800-388-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4575 W CAPOVILLA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891185044",
            "telephone_number": "702-880-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUCARE COMMUNITY LIVING CORPORATION - NEVADA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-23",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "RODENBERG-ROBERTS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "VP & SR ASST GENERAL COUNSEL",
        "authorized_official_telephone_number": "952-836-2234"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.