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7039 Mesquite St Las Vegas NV 89110 | |
| (909) 894-8607 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Early Intervention Provider Agency |
| Location | 7039 Mesquite St, Las Vegas, Nevada |
| Authorized Official Name and Position | Ashleigh Diane Cook (OWNER) |
| Authorized Official Contact | 9098948607 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7039 Mesquite St. Las Vegas NV 89110 Ph: (909) 894-8607 | 7039 Mesquite St Las Vegas NV 89110 Ph: (909) 894-8607 |
| NPI Number | 1093159162 |
|---|---|
| Provider Enumeration Date | 04/19/2013 |
| Last Update Date | 04/23/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093159162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Primary |
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