Lifeshare Care Home Nevada

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

6087AGC-6 Issued in NV

Legal business name

LIFESHARE CARE HOME NEVADA

Practice address

7925 W Rosada Way
Las Vegas, NV 89149-5208

Phone

(702) 722-6783

Fax

(702) 998-0280

NPI assigned

Jan 12, 2016

Organization subpart

No

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

Authorized official

Name

Belinda Devano

Title

President/Administrator

Phone

(408) 854-0735

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452556800000",
    "number": "1811353576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2795 GEORGE BLAUER PL",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951351281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7925 W ROSADA WAY",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891495208",
            "telephone_number": "702-722-6783",
            "fax_number": "702-998-0280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESHARE CARE HOME NEVADA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-12",
        "last_updated": "2016-01-12",
        "status": "A",
        "authorized_official_last_name": "DEVANO",
        "authorized_official_first_name": "BELINDA",
        "authorized_official_title_or_position": "PRESIDENT/ADMINISTRATOR",
        "authorized_official_telephone_number": "408-854-0735"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NV",
            "license": "6087AGC-6",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9005057235",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Disabilities Residential Treatment Facility in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Disabilities Residential Treatment Facility in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.