| Steadfast Behavioral Clinic Llc | |
|
8612 Copper Knoll Ave Las Vegas NV 89129-7649 | |
| (323) 338-6101 | |
| Not Available |
| Full Name | Steadfast Behavioral Clinic Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 8612 Copper Knoll Ave, Las Vegas, Nevada |
| Authorized Official Name and Position | Ma Victoria Escarda (MANAGING MEMBER) |
| Authorized Official Contact | 3233386101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Steadfast Behavioral Clinic Llc 8612 Copper Knoll Ave Las Vegas NV 89129-7649 Ph: (323) 338-6101 | Steadfast Behavioral Clinic Llc 8612 Copper Knoll Ave Las Vegas NV 89129-7649 Ph: (323) 338-6101 |
| NPI Number | 1447866801 |
|---|---|
| Provider Enumeration Date | 09/21/2020 |
| Last Update Date | 09/21/2020 |
| Certification Date | 09/21/2020 |
| Medicare PECOS PAC ID | 1850705047 |
|---|---|
| Medicare Enrollment ID | O20210129000792 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447866801 | NPI | - | NPPES |
| Provider Name | Emma B Cempron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073709192 PECOS PAC ID: 9234322108 Enrollment ID: I20101023000190 |
| Provider Name | Ma Victoria Escarda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962883553 PECOS PAC ID: 6800100678 Enrollment ID: I20150806012717 |
| Provider Name | Reanna Nicole Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932882172 PECOS PAC ID: 4385090190 Enrollment ID: I20231031002520 |
| Provider Name | Alan Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689429326 PECOS PAC ID: 0244772234 Enrollment ID: I20240605002830 |
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