| Beautiful Moon Health & Wellness, Llc | |
|
6935 Aliante Pkwy Ste 104-217 North Las Vegas NV 89084-5818 | |
| (510) 256-9794 | |
| Not Available |
| Full Name | Beautiful Moon Health & Wellness, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 6935 Aliante Pkwy Ste 104-217, North Las Vegas, Nevada |
| Authorized Official Name and Position | Javonni Henderson (OWNER/CEO) |
| Authorized Official Contact | 5102569794 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beautiful Moon Health & Wellness, Llc 6935 Aliante Pkwy Ste 104-217 North Las Vegas NV 89084-5818 Ph: (510) 256-9794 | Beautiful Moon Health & Wellness, Llc 6935 Aliante Pkwy Ste 104-217 North Las Vegas NV 89084-5818 Ph: (510) 256-9794 |
| NPI Number | 1386314466 |
|---|---|
| Provider Enumeration Date | 09/20/2021 |
| Last Update Date | 09/20/2021 |
| Certification Date | 09/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386314466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
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