| 2d Change Inc. | |
|
2725 S. Jones Blvd. Suite 101 Las Vegas NV 89146 | |
| (702) 829-6429 | |
| (702) 208-2090 |
| Full Name | 2d Change Inc. |
|---|---|
| Speciality | Counselor |
| Location | 2725 S. Jones Blvd. Suite 101, Las Vegas, Nevada |
| Authorized Official Name and Position | Roosevelt Daymon (PRESIDENT) |
| Authorized Official Contact | 7025883425 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 2d Change Inc. Po Box 9602 Nellis Afb NV 89191 Ph: (702) 588-3425 | 2d Change Inc. 2725 S. Jones Blvd. Suite 101 Las Vegas NV 89146 Ph: (702) 829-6429 |
| NPI Number | 1417550567 |
|---|---|
| Provider Enumeration Date | 11/20/2020 |
| Last Update Date | 04/27/2021 |
| Certification Date | 04/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417550567 | NPI | - | NPPES |
| NV20071459752 | Other | NV | STATE BUSINESS LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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