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2620 Regatta Dr Ste 102 Las Vegas NV 89128-6892 | |
| (725) 228-8029 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2620 Regatta Dr Ste 102, Las Vegas, Nevada |
| Authorized Official Name and Position | Joseph Morris (OWNER) |
| Authorized Official Contact | 7252288029 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2620 Regatta Dr Ste 102 Las Vegas NV 89128-6892 Ph: (725) 228-8029 | 2620 Regatta Dr Ste 102 Las Vegas NV 89128-6892 Ph: (725) 228-8029 |
| NPI Number | 1124891270 |
|---|---|
| Provider Enumeration Date | 10/31/2023 |
| Last Update Date | 11/16/2023 |
| Certification Date | 11/16/2023 |
| Medicare PECOS PAC ID | 0547792723 |
|---|---|
| Medicare Enrollment ID | O20241011003775 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124891270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Joseph Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578290748 PECOS PAC ID: 1456715135 Enrollment ID: I20230913003401 |
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