| Cognitive Care Support Services L.l.c. | |
|
2831 Saint Rose Pkwy Ste 200 Henderson NV 89052-4841 | |
| (405) 212-7348 | |
| Not Available |
| Full Name | Cognitive Care Support Services L.l.c. |
|---|---|
| Speciality | Social Worker |
| Location | 2831 Saint Rose Pkwy Ste 200, Henderson, Nevada |
| Authorized Official Name and Position | Deanna Beth Moslander (OWNER) |
| Authorized Official Contact | 4052127348 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cognitive Care Support Services L.l.c. 2831 Saint Rose Pkwy Ste 200 Henderson NV 89052-4841 Ph: (405) 212-7348 | Cognitive Care Support Services L.l.c. 2831 Saint Rose Pkwy Ste 200 Henderson NV 89052-4841 Ph: (405) 212-7348 |
| NPI Number | 1538736103 |
|---|---|
| Provider Enumeration Date | 06/10/2021 |
| Last Update Date | 06/10/2021 |
| Certification Date | 06/10/2021 |
| Medicare PECOS PAC ID | 2769872464 |
|---|---|
| Medicare Enrollment ID | O20211213002018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538736103 | NPI | - | NPPES |
| 1376889378 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Deanna B Moslander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376889378 PECOS PAC ID: 4486044187 Enrollment ID: I20211216002744 |
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