| Portillo Genesis Therapy Pllc | |
|
732 S 6th St Ste R Las Vegas NV 89101-6948 | |
| (775) 295-5114 | |
| Not Available |
| Full Name | Portillo Genesis Therapy Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 732 S 6th St Ste R, Las Vegas, Nevada |
| Authorized Official Name and Position | Margarita Portillo (OWNER) |
| Authorized Official Contact | 7752955114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portillo Genesis Therapy Pllc 1295 Grand Summit Dr Apt G252 Reno NV 89523-2597 Ph: (775) 295-5114 | Portillo Genesis Therapy Pllc 732 S 6th St Ste R Las Vegas NV 89101-6948 Ph: (775) 295-5114 |
| NPI Number | 1437964590 |
|---|---|
| Provider Enumeration Date | 02/07/2025 |
| Last Update Date | 02/07/2025 |
| Certification Date | 02/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437964590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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