Provider Demographics
NPI:1780869115
Name:CARSON TAHOE CONTINUING CARE HOSPITAL INC
Entity type:Organization
Organization Name:CARSON TAHOE CONTINUING CARE HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP CFO
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUCERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-445-5543
Mailing Address - Street 1:775 FLEISCHMANN WAY
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-2995
Mailing Address - Country:US
Mailing Address - Phone:775-445-7790
Mailing Address - Fax:
Practice Address - Street 1:775 FLEISCHMANN WAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-2995
Practice Address - Country:US
Practice Address - Phone:775-445-7790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV292008Medicare Oscar/Certification