| American Grace Wellness Center Llc | |
|
3925 N. Martin Luther King Blvd Suite 212 North Las Vegas NV 89032-7676 | |
| (702) 444-0235 | |
| (702) 992-3505 |
| Full Name | American Grace Wellness Center Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3925 N. Martin Luther King Blvd Suite 212, North Las Vegas, Nevada |
| Authorized Official Name and Position | Jacqueline Glasper-sattwhite (CEO/ CLINICAL SUPERVISOR) |
| Authorized Official Contact | 7028830102 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| American Grace Wellness Center Llc 3925 N. Martin Luther King Blvd Suite 212 North Las Vegas NV 89032-7676 Ph: (702) 444-0235 | American Grace Wellness Center Llc 3925 N. Martin Luther King Blvd Suite 212 North Las Vegas NV 89032-7676 Ph: (702) 444-0235 |
| NPI Number | 1831574136 |
|---|---|
| Provider Enumeration Date | 07/28/2015 |
| Last Update Date | 11/10/2022 |
| Certification Date | 11/10/2022 |
| Medicare PECOS PAC ID | 2062809049 |
|---|---|
| Medicare Enrollment ID | O20220421000101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831574136 | NPI | - | NPPES |
| 9028-C | Other | NV | NEVADA STATE BOARD OF EXAMINERS FOR SOCIAL WORKERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jacqueline Glasper-sattwhite |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285910075 PECOS PAC ID: 3971990953 Enrollment ID: I20220421000116 |
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