Provider Demographics
NPI:1922496868
Name:SIENNA HEIGHTS SURGERY CENTER,LLC
Entity Type:Organization
Organization Name:SIENNA HEIGHTS SURGERY CENTER,LLC
Other - Org Name:SIENA SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FORAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-581-8251
Mailing Address - Street 1:2865 SIENA HEIGHTS DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4167
Mailing Address - Country:US
Mailing Address - Phone:702-586-3211
Mailing Address - Fax:702-586-4922
Practice Address - Street 1:2865 SIENA HEIGHTS DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4167
Practice Address - Country:US
Practice Address - Phone:702-586-3212
Practice Address - Fax:702-586-4922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA1903X
NV261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical