Provider Demographics
NPI:1679929483
Name:REM NEVADA INC
Entity Type:Organization
Organization Name:REM NEVADA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP & SR. ASST GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:RODENBERG-ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-836-2234
Mailing Address - Street 1:8010 W SAHARA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7905
Mailing Address - Country:US
Mailing Address - Phone:702-889-9240
Mailing Address - Fax:702-889-6545
Practice Address - Street 1:8010 W SAHARA AVE STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-7905
Practice Address - Country:US
Practice Address - Phone:800-388-5150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1000063-341385H00000X
NV16-00022798385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care