Organization Active NPI

Laurelwood Group Home, LLC

  • Adult Care Home Facility
  • Las Vegas, NV
National Provider Identifier
1669215539
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
LAURELWOOD GROUP HOME, LLC
Practice address
4752 Torrence Dr
Las Vegas, NV 89103-4336
Phone
(702) 580-5123
Fax
(702) 570-5785
NPI assigned
Jun 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Authorized official

Name
Goran Bekirov
Title
Managing Member
Phone
(702) 580-5123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X Primary

Addresses

Primary practice location

4752 Torrence Dr
Las Vegas, NV 89103-4336

Mailing address

4752 Torrence Dr
Las Vegas, NV 89103-4336
Phone (702) 580-5123

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
29D2261562Laurelwood Group Home, LLC4752 Torrence Dr, Las Vegas, NV 89103Certificate of waiverJun 1, 2028

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1669215539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4752 TORRENCE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891034336",
            "telephone_number": "702-580-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4752 TORRENCE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891034336",
            "telephone_number": "702-580-5123",
            "fax_number": "702-570-5785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURELWOOD GROUP HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "BEKIROV",
        "authorized_official_first_name": "GORAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "702-580-5123"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.