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2030 E Flamingo Rd Ste 140 Las Vegas NV 89119-0831 | |
| (702) 510-3352 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2030 E Flamingo Rd Ste 140, Las Vegas, Nevada |
| Authorized Official Name and Position | Scott L Thompson (MANAGING MEMEBER) |
| Authorized Official Contact | 8087809117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
7471 Proud Meadows St Las Vegas NV 89131-2340 Ph: (702) 510-3352 | 2030 E Flamingo Rd Ste 140 Las Vegas NV 89119-0831 Ph: (702) 510-3352 |
| NPI Number | 1326362930 |
|---|---|
| Provider Enumeration Date | 03/25/2010 |
| Last Update Date | 05/10/2019 |
| Medicare PECOS PAC ID | 3476896317 |
|---|---|
| Medicare Enrollment ID | O20200219000824 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326362930 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5316-C (Nevada) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Scott L Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639367006 PECOS PAC ID: 0941387690 Enrollment ID: I20080407000097 |
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