Provider Demographics
NPI:1972759108
Name:CHILDREN'S ACUTE CARE
Entity Type:Organization
Organization Name:CHILDREN'S ACUTE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTENDING IN PICU
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:MARIANO
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:702-395-7282
Mailing Address - Street 1:653 N TOWN CENTER DR STE 408
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-0518
Mailing Address - Country:US
Mailing Address - Phone:702-395-7282
Mailing Address - Fax:
Practice Address - Street 1:653 N TOWN CENTER DR STE 408
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-0518
Practice Address - Country:US
Practice Address - Phone:702-395-7282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVTAPN700431282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren