Provider Demographics
NPI:1285257691
Name:ATRIUM NEVADA, LLC
Entity type:Organization
Organization Name:ATRIUM NEVADA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JANYVILL
Authorized Official - Middle Name:
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-301-8862
Mailing Address - Street 1:8490 S EASTERN AVE STE B1
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2806
Mailing Address - Country:US
Mailing Address - Phone:702-676-1130
Mailing Address - Fax:702-895-9992
Practice Address - Street 1:8490 S EASTERN AVE STE B1
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2806
Practice Address - Country:US
Practice Address - Phone:702-676-1130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based