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9414 W Lake Mead Blvd Las Vegas NV 89134-8312 | |
| (702) 878-0554 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 9414 W Lake Mead Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Roberta Vande Voort (CEO) |
| Authorized Official Contact | 7028780554 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9414 W Lake Mead Blvd Las Vegas NV 89134-8312 Ph: (702) 878-0554 | 9414 W Lake Mead Blvd Las Vegas NV 89134-8312 Ph: (702) 878-0554 |
| NPI Number | 1043621204 |
|---|---|
| Provider Enumeration Date | 05/09/2014 |
| Last Update Date | 05/09/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043621204 | NPI | - | NPPES |
| 193400000X | Other | HEALTH CARE PROVIDER TAXONOMY CODE SET |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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