Provider Demographics
NPI:1386642460
Name:DESERT HEALTH CARE FACILITIES, INC.
Entity Type:Organization
Organization Name:DESERT HEALTH CARE FACILITIES, INC.
Other - Org Name:MESQUITE HEALTH CARE, LLC- HIGHLAND MANOR OF MESQUITE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-343-1550
Mailing Address - Street 1:272 PIONEER BLVD
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:NV
Mailing Address - Zip Code:89027
Mailing Address - Country:US
Mailing Address - Phone:702-346-7666
Mailing Address - Fax:702-346-7276
Practice Address - Street 1:272 PIONEER BLVD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027
Practice Address - Country:US
Practice Address - Phone:702-346-7666
Practice Address - Fax:702-346-7276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2343SNF13314000000X
NV2343SNF-13314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ51Medicaid
NV001902250Medicaid
NV001902250Medicaid