| Life Gateway | |
|
2128 Pink Coral Dr North Las Vegas NV 89031-0985 | |
| (702) 234-9822 | |
| Not Available |
| Full Name | Life Gateway |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 2128 Pink Coral Dr, North Las Vegas, Nevada |
| Authorized Official Name and Position | Cynthia Ewell (MANAGING MEMBER) |
| Authorized Official Contact | 7027529274 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Gateway 3605 Mountain Crest St Las Vegas NV 89129-7864 Ph: () - | Life Gateway 2128 Pink Coral Dr North Las Vegas NV 89031-0985 Ph: (702) 234-9822 |
| NPI Number | 1710246921 |
|---|---|
| Provider Enumeration Date | 05/08/2012 |
| Last Update Date | 05/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710246921 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (Nevada) | Primary |
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