Provider Demographics
NPI:1376164301
Name:SACHELE SENIOR GUEST HOME II
Entity Type:Organization
Organization Name:SACHELE SENIOR GUEST HOME II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROWENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-493-2727
Mailing Address - Street 1:3397 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-3424
Mailing Address - Country:US
Mailing Address - Phone:702-493-2727
Mailing Address - Fax:
Practice Address - Street 1:3397 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-3424
Practice Address - Country:US
Practice Address - Phone:024-932-7277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SACHELE SENIOR GUEST HOME I&II
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-30
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home