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8225 W Sahara Ave Ste H Las Vegas NV 89117-8929 | |
| (702) 476-2899 | |
| (702) 476-1575 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8225 W Sahara Ave Ste H, Las Vegas, Nevada |
| Authorized Official Name and Position | Jennie Inguanzo (OWNER) |
| Authorized Official Contact | 7022177683 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8225 W Sahara Ave Ste H Las Vegas NV 89117-8929 Ph: (702) 476-2899 | 8225 W Sahara Ave Ste H Las Vegas NV 89117-8929 Ph: (702) 476-2899 |
| NPI Number | 1447596150 |
|---|---|
| Provider Enumeration Date | 12/27/2012 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447596150 | NPI | - | NPPES |
| 1447596150 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | NV20101749146 (Nevada) | Primary |
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