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2380 W. Wilson Rd Pahrump NV 89048 | |
| (775) 751-6140 | |
| (775) 751-6143 |
| Full Name | |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2380 W. Wilson Rd, Pahrump, Nevada |
| Authorized Official Name and Position | Anita Ann Anderson (PROPRIETOR) |
| Authorized Official Contact | 7757516140 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2380 W. Wilson Rd Pahrump NV 89048 Ph: (775) 751-6140 | 2380 W. Wilson Rd Pahrump NV 89048 Ph: (775) 751-6140 |
| NPI Number | 1518175454 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 07/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518175454 | NPI | - | NPPES |
| 1518175454 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | FF125400309 (Nevada) | Primary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
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