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1312 E Tonopah Ave N Las Vegas NV 89030-7111 | |
| (702) 399-4791 | |
| (702) 399-1547 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1312 E Tonopah Ave, N Las Vegas, Nevada |
| Authorized Official Name and Position | Thomas G Chase (CEO) |
| Authorized Official Contact | 7758871590 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1802 N Carson St Suite 100 Carson City NV 89701-1215 Ph: (775) 888-6610 | 1312 E Tonopah Ave N Las Vegas NV 89030-7111 Ph: (702) 399-4791 |
| NPI Number | 1558489427 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558489427 | NPI | - | NPPES |
| 100505012 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Nevada) | Primary |
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