Provider Demographics
NPI:1336674985
Name:ORMSBY HEIGHTS RESIDENTIAL CARE
Entity Type:Organization
Organization Name:ORMSBY HEIGHTS RESIDENTIAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:N
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-450-8740
Mailing Address - Street 1:210 S ORMSBY BLVD
Mailing Address - Street 2:615 W. 5TH ST
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-4549
Mailing Address - Country:US
Mailing Address - Phone:775-445-0214
Mailing Address - Fax:775-883-3116
Practice Address - Street 1:210 S ORMSBY BLVD
Practice Address - Street 2:615 W. 5TH ST
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4549
Practice Address - Country:US
Practice Address - Phone:775-445-0214
Practice Address - Fax:775-883-3116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7210AGC-3310400000X
NV7687AGC-5310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility