Provider Demographics
NPI:1740477199
Name:NEVADA SENIOR SERVICES INC
Entity type:Organization
Organization Name:NEVADA SENIOR SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:FACHE
Authorized Official - Phone:702-648-3425
Mailing Address - Street 1:901 N JONES BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-1603
Mailing Address - Country:US
Mailing Address - Phone:702-648-3425
Mailing Address - Fax:702-648-1408
Practice Address - Street 1:901 N JONES BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-1603
Practice Address - Country:US
Practice Address - Phone:702-648-3425
Practice Address - Fax:702-648-1408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100505672Medicaid