Provider Demographics
NPI:1861689028
Name:NEVADA REHABILITATION INSTITUTE LLC
Entity Type:Organization
Organization Name:NEVADA REHABILITATION INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:S
Authorized Official - Last Name:MICIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-869-4401
Mailing Address - Street 1:2701 N TENAYA WAY
Mailing Address - Street 2:STE 290
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0478
Mailing Address - Country:US
Mailing Address - Phone:702-869-4401
Mailing Address - Fax:702-869-9904
Practice Address - Street 1:2701 N TENAYA WAY
Practice Address - Street 2:STE 290
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0478
Practice Address - Country:US
Practice Address - Phone:702-869-4401
Practice Address - Fax:702-869-9904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty