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3067 E Warm Springs Rd Ste 100 Las Vegas NV 89120 | |
| (702) 650-6508 | |
| (702) 472-8704 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3067 E Warm Springs Rd Ste 100, Las Vegas, Nevada |
| Authorized Official Name and Position | Kaycee Israel (MANAGER) |
| Authorized Official Contact | 7029560993 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3067 E Warm Springs Rd Ste 100 Las Vegas NV 89120-3750 Ph: (702) 650-6508 | 3067 E Warm Springs Rd Ste 100 Las Vegas NV 89120 Ph: (702) 650-6508 |
| NPI Number | 1508374885 |
|---|---|
| Provider Enumeration Date | 01/19/2018 |
| Last Update Date | 08/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508374885 | NPI | - | NPPES |
| 1104195544 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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