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2755 E Desert Inn Rd Ste 180 Las Vegas NV 89121-3694 | |
| (702) 602-5106 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2755 E Desert Inn Rd Ste 180, Las Vegas, Nevada |
| Authorized Official Name and Position | Ibiandi Marquetti-varona (CEO) |
| Authorized Official Contact | 7026857770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2755 E Desert Inn Rd Ste 180 Las Vegas NV 89121-3694 Ph: (702) 602-5106 | 2755 E Desert Inn Rd Ste 180 Las Vegas NV 89121-3694 Ph: (702) 602-5106 |
| NPI Number | 1508486317 |
|---|---|
| Provider Enumeration Date | 04/21/2020 |
| Last Update Date | 04/18/2022 |
| Certification Date | 04/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508486317 | NPI | - | NPPES |
| V60071 | Other | NV | NV MEDICARE |
| V60071 | Medicaid | NV |
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