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2441 Tech Center Ct Suite 109 Las Vegas NV 89128-0804 | |
| (702) 810-4122 | |
| (702) 240-1625 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2441 Tech Center Ct, Las Vegas, Nevada |
| Authorized Official Name and Position | Holly Adele Andres (OWNER/MANAGER) |
| Authorized Official Contact | 7022049495 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7500 W Lake Mead Blvd Suite 9-472 Las Vegas NV 89128-0297 Ph: (702) 204-9495 | 2441 Tech Center Ct Suite 109 Las Vegas NV 89128-0804 Ph: (702) 810-4122 |
| NPI Number | 1275774978 |
|---|---|
| Provider Enumeration Date | 03/10/2009 |
| Last Update Date | 03/10/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275774978 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 4097-C (Nevada) | Primary |
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