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800 N Rainbow Blvd #161 Las Vegas NV 89107-1189 | |
| (702) 800-4632 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 800 N Rainbow Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Daniel Wiafe (CEO) |
| Authorized Official Contact | 9188505109 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
800 N Rainbow Blvd #161 Las Vegas NV 89107-1189 Ph: (702) 800-4632 | 800 N Rainbow Blvd #161 Las Vegas NV 89107-1189 Ph: (702) 800-4632 |
| NPI Number | 1316354202 |
|---|---|
| Provider Enumeration Date | 07/13/2014 |
| Last Update Date | 07/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316354202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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