| Cic Lv | |
|
401 S Martin Luther King Blvd Las Vegas NV 89106-4313 | |
| (702) 385-3330 | |
| (702) 385-5519 |
| Full Name | Cic Lv |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 401 S Martin Luther King Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Erin Kinard (AREA DIRECTOR) |
| Authorized Official Contact | 7023852090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cic Lv 1711 Whitney Mesa Dr Henderson NV 89014-2080 Ph: (702) 385-2090 | Cic Lv 401 S Martin Luther King Blvd Las Vegas NV 89106-4313 Ph: (702) 385-3330 |
| NPI Number | 1144638180 |
|---|---|
| Provider Enumeration Date | 07/22/2014 |
| Last Update Date | 07/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144638180 | NPI | - | NPPES |
| 100508912 | Medicaid | NV | |
| 1851574305 | Other | NV | PT17 NPI |
| 100511279 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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