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3320 N Buffalo Dr Ste 207 Las Vegas NV 89129-7411 | |
| (702) 720-2565 | |
| (702) 552-5163 |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3320 N Buffalo Dr Ste 207, Las Vegas, Nevada |
| Authorized Official Name and Position | Jody Williams (OWNER) |
| Authorized Official Contact | 7027202565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 753762 Las Vegas NV 89136-3762 Ph: (702) 720-2565 | 3320 N Buffalo Dr Ste 207 Las Vegas NV 89129-7411 Ph: (702) 720-2565 |
| NPI Number | 1023697364 |
|---|---|
| Provider Enumeration Date | 04/05/2021 |
| Last Update Date | 11/21/2024 |
| Certification Date | 11/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023697364 | NPI | - | NPPES |
| 100509776 | Medicaid | NV | |
| 100509777 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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