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314 Foremaster Ln Las Vegas NV 89101-1008 | |
| (702) 229-2484 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | General Practice |
| Location | 314 Foremaster Ln, Las Vegas, Nevada |
| Authorized Official Name and Position | Maurice Cloutier (MANAGER) |
| Authorized Official Contact | 7022292485 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
495 S Main St Las Vegas NV 89101-6318 Ph: (702) 229-6906 | 314 Foremaster Ln Las Vegas NV 89101-1008 Ph: (702) 229-2484 |
| NPI Number | 1184216970 |
|---|---|
| Provider Enumeration Date | 02/03/2021 |
| Last Update Date | 07/15/2024 |
| Certification Date | 07/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184216970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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