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314 Foremaster Ln Las Vegas NV 89101-1008 | |
| (702) 229-2485 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 314 Foremaster Ln, Las Vegas, Nevada |
| Authorized Official Name and Position | Lindy Cooksey (SR NEIGHBORHOOD OUTREACH SPECIALIST) |
| Authorized Official Contact | 7022294695 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
495 S Main St Dept Of Las Vegas NV 89101-6318 Ph: (702) 229-2485 | 314 Foremaster Ln Las Vegas NV 89101-1008 Ph: (702) 229-2485 |
| NPI Number | 1104681691 |
|---|---|
| Provider Enumeration Date | 02/14/2024 |
| Last Update Date | 12/17/2024 |
| Certification Date | 12/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104681691 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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