| Peavine Counseling Llc | |
|
480 W Bonanza Rd Las Vegas NV 89106-3227 | |
| (775) 560-9623 | |
| (866) 348-2644 |
| Full Name | Peavine Counseling Llc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 480 W Bonanza Rd, Las Vegas, Nevada |
| Authorized Official Name and Position | Ulla Yandell (MANAGING MEMBER) |
| Authorized Official Contact | 7755609623 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peavine Counseling Llc 7117 Lakeland Rd Las Vegas NV 89145-6027 Ph: (775) 560-9623 | Peavine Counseling Llc 480 W Bonanza Rd Las Vegas NV 89106-3227 Ph: (775) 560-9623 |
| NPI Number | 1972272896 |
|---|---|
| Provider Enumeration Date | 09/13/2021 |
| Last Update Date | 09/13/2021 |
| Certification Date | 09/10/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972272896 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |
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