Las Vegas Group Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LAS VEGAS GROUP HOME LLC

Practice address

1680 Sombrero Dr
Las Vegas, NV 89169-2564

Phone

(702) 209-2580

Fax

(702) 202-4093

NPI assigned

Aug 17, 2021

Last updated

Aug 17, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joe RabinNPI 1679146872

Title

Managing Member

Phone

(818) 335-2278

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joe Rabin

  • Assisted Living Facility
  • Las Vegas, NV
  • NPI 1679146872
  Authorized official Same address or phone

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1821764135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 SOMBRERO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891692564",
            "telephone_number": "702-209-2580",
            "fax_number": "702-202-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 SOMBRERO DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891692564",
            "telephone_number": "702-209-2580",
            "fax_number": "702-202-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS VEGAS GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "RABIN",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "818-335-2278"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165347",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Mail",
            "affiliation": "N",
            "address_1": "1680 Sombrero Dr",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891692564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Assisted Living Facility in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Assisted Living Facility in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.