NPIMap

Organization Active NPI

Las Vegas Recovery Hospital LLC

  • General Acute Care Hospital
  • Henderson, NV
National Provider Identifier
1508685629
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
LAS VEGAS RECOVERY HOSPITAL LLC
Practice address
102 E Lake Mead Pkwy
Henderson, NV 89015-5575
Phone
(732) 714-5551
NPI assigned
Oct 7, 2024
Last updated
Oct 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Authorized official

Name
Mr. Ben Levin
Title
President
Phone
(732) 714-5551

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU Primary

Addresses

Primary practice location

102 E Lake Mead Pkwy
Henderson, NV 89015-5575

Mailing address

850 Towbin Ave
Lakewood, NJ 08701-5928
Phone (732) 714-5551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251211002531 NV Part A Provider - Hospital 8022502525 Practice locations: Henderson, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508685629. Details of each certification follow.

Hospital certification: CCN 290063

Legal name
LAS VEGAS RECOVERY HOSPITAL LLC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Mar 24, 2026
Last certification
Mar 24, 2026
Beds
68
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Enrollment address
102 E Lake Mead Pkwy
Henderson, NV 89015-5575
Main/Primary Hospital Location
Hospital subgroups
Acute care

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Las Vegas Recovery Hospital LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Stacey Zierath Individual Corporate OfficerChief Executive Officer Jan 1, 2025
W-2 Managing EmployeeChief Executive Officer Jan 1, 2025
Benzion Avraham Levin Individual 5% Or Greater Indirect Ownership Interest Jul 17, 2024 10%
Operational/Managerial Control Jan 1, 2025
Koznitz 2024 NGCG Trust Organization, Lakewood, NJ 5% Or Greater Direct Ownership Interest May 14, 2024 89%
Ice Health LLC Organization, Lakewood, NJ LLC 5% Or Greater Direct Ownership Interest Jul 17, 2024 10%

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1728259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730160000000",
    "number": "1508685629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 TOWBIN AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015928",
            "telephone_number": "732-714-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E LAKE MEAD PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890155575",
            "telephone_number": "732-714-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS VEGAS RECOVERY HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "LEVIN",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-714-5551",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.