Timeless Individual Residential Care

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

4279HIC-9 Issued in NV

Legal business name

TIMELESS INDIVIDUAL RESIDENTIAL CARE

Practice address

4617 Santa Monica Ave
North Las Vegas, NV 89032-2831

Phone

(702) 395-5834

Fax

(702) 645-1020

NPI assigned

Dec 17, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Carrie Sanders Troutman

Title

Director

Phone

(702) 395-5834

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450310400000",
    "number": "1942665922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4617 SANTA MONICA AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890322831",
            "telephone_number": "702-395-5834",
            "fax_number": "702-645-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 SANTA MONICA AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890322831",
            "telephone_number": "702-395-5834",
            "fax_number": "702-645-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMELESS INDIVIDUAL RESIDENTIAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A",
        "authorized_official_last_name": "TROUTMAN",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "SANDERS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "702-395-5834",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NV",
            "license": "4279HIC-9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Thurman
• Achille Tiam, PHARM.D.
• Lindsey F Tiberti, PHARM.D.
• Casey Matthew Tiefenthaler, PHARMD
• Ana Tift
• Jo Yvonne Timmons
• Tingfafa LLC
• Ellen Tinney
• Tierney Lynne Tirey, M.D.
• Teresa Tisdale

• Adult Care Home Facility in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Adult Care Home Facility in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.