Provider Demographics
NPI:1306405808
Name:AS TIME GOES BY
Entity Type:Organization
Organization Name:AS TIME GOES BY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KERN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:702-683-4568
Mailing Address - Street 1:4125 N BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-4864
Mailing Address - Country:US
Mailing Address - Phone:702-655-5557
Mailing Address - Fax:702-655-2743
Practice Address - Street 1:4240 AL CARRISON ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-4845
Practice Address - Country:US
Practice Address - Phone:702-658-3300
Practice Address - Fax:702-658-0047
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AS TIME GOES BY VII
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-08
Last Update Date:2019-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)