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1515 E Tropicana Ave Ste 345 Las Vegas NV 89119-6542 | |
| (702) 702-1731 | |
| (702) 979-2486 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1515 E Tropicana Ave Ste 345, Las Vegas, Nevada |
| Authorized Official Name and Position | O Miranda (MANAGING MEMBER) |
| Authorized Official Contact | 7020000000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1515 E Tropicana Ave Ste 345 Las Vegas NV 89119-6542 Ph: (702) 702-1731 | 1515 E Tropicana Ave Ste 345 Las Vegas NV 89119-6542 Ph: (702) 702-1731 |
| NPI Number | 1245937507 |
|---|---|
| Provider Enumeration Date | 02/07/2023 |
| Last Update Date | 11/29/2024 |
| Certification Date | 11/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245937507 | NPI | - | NPPES |
| 2105098334 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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