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730 N Eastern Ave Suite 110 Las Vegas NV 89101-2883 | |
(702) 772-4864 | |
(866) 442-8199 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 730 N Eastern Ave, Las Vegas, Nevada |
Authorized Official Name and Position | Yolanda A. Trevino (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 7027724864 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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730 N. Eastern Ave. Suite 110 Las Vegas NV 89101 Ph: (702) 772-4864 | 730 N Eastern Ave Suite 110 Las Vegas NV 89101-2883 Ph: (702) 772-4864 |
NPI Number | 1619248309 |
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Provider Enumeration Date | 01/26/2012 |
Last Update Date | 03/08/2012 |
Identifier | Type | State | Issuer |
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1619248309 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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