| Proud Moments Aba Of Nevada Llc | |
|
1775 Village Center Cir Ste 190 Las Vegas NV 89134-0571 | |
| (877) 768-2221 | |
| Not Available |
| Full Name | Proud Moments Aba Of Nevada Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1775 Village Center Cir Ste 190, Las Vegas, Nevada |
| Authorized Official Name and Position | Yosef Goldfeder (PRESIDENT) |
| Authorized Official Contact | 7182155311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proud Moments Aba Of Nevada Llc 1449 37 Street Suite 100 Brooklyn NY 11218 Ph: (718) 215-5311 | Proud Moments Aba Of Nevada Llc 1775 Village Center Cir Ste 190 Las Vegas NV 89134-0571 Ph: (877) 768-2221 |
| NPI Number | 1043780695 |
|---|---|
| Provider Enumeration Date | 11/27/2018 |
| Last Update Date | 02/19/2020 |
| Certification Date | 02/19/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043780695 | NPI | - | NPPES |
| 1-13-13480 | Other | BACB |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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