| Prime Healthcare Services North Vista Llc | |
|
1409 E Lake Mead Blvd North Las Vegas NV 89030-7120 | |
| (702) 649-7711 | |
| Not Available |
| Full Name | Prime Healthcare Services North Vista Llc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1409 E Lake Mead Blvd, North Las Vegas, Nevada |
| Authorized Official Name and Position | Prem Reddy (CHAIRMAN/PRESIDENT) |
| Authorized Official Contact | 9092354400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Healthcare Services North Vista Llc 1409 E Lake Mead Blvd North Las Vegas NV 89030-7120 Ph: (702) 649-7711 | Prime Healthcare Services North Vista Llc 1409 E Lake Mead Blvd North Las Vegas NV 89030-7120 Ph: (702) 649-7711 |
| NPI Number | 1497153530 |
|---|---|
| Provider Enumeration Date | 12/05/2014 |
| Last Update Date | 12/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497153530 | NPI | - | NPPES |
| 100502300 | Medicaid | NV | |
| 100502301 | Medicaid | NV | |
| 100502299 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 649HOS-34 (Nevada) | Primary |
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