Provider Demographics
NPI:1689102139
Name:PAHRUMP SENIOR CENTER, INC.
Entity Type:Organization
Organization Name:PAHRUMP SENIOR CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SITE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:NITCHALS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-419-5185
Mailing Address - Street 1:1370 W BASIN AVE
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89060-4501
Mailing Address - Country:US
Mailing Address - Phone:775-727-5008
Mailing Address - Fax:775-751-6831
Practice Address - Street 1:1370 W BASIN AVE
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89060-4501
Practice Address - Country:US
Practice Address - Phone:775-727-5008
Practice Address - Fax:775-751-6831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV347B00000X
NVXXXXX347B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus