Provider Demographics
NPI:1629418629
Name:AACRES NV, LLC
Entity Type:Organization
Organization Name:AACRES NV, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-209-2777
Mailing Address - Street 1:5709 W SUNSET HWY
Mailing Address - Street 2:STE 100
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224
Mailing Address - Country:US
Mailing Address - Phone:509-328-2740
Mailing Address - Fax:509-789-3323
Practice Address - Street 1:4340 SOUTH VALLEY VIEW BLVD
Practice Address - Street 2:STE 220
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103
Practice Address - Country:US
Practice Address - Phone:702-227-4545
Practice Address - Fax:702-259-0545
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMBASSY MANAGEMENT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-05
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
320900000X, 343900000X
NVNV20081362263385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care