| Jd Tom Ventures Llc | |
|
1460 E Calvada Blvd Pahrump NV 89048-5822 | |
| (702) 904-0260 | |
| Not Available |
| Full Name | Jd Tom Ventures Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1460 E Calvada Blvd, Pahrump, Nevada |
| Authorized Official Name and Position | David Hardy (ADMINISTRATOR) |
| Authorized Official Contact | 7029040260 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jd Tom Ventures Llc 9867 Antelope Canyon Ave Las Vegas NV 89147-7739 Ph: () - | Jd Tom Ventures Llc 1460 E Calvada Blvd Pahrump NV 89048-5822 Ph: (702) 904-0260 |
| NPI Number | 1649873571 |
|---|---|
| Provider Enumeration Date | 11/21/2020 |
| Last Update Date | 04/13/2021 |
| Certification Date | 04/13/2021 |
| Medicare PECOS PAC ID | 9638586936 |
|---|---|
| Medicare Enrollment ID | O20210405000820 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649873571 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
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