| Great Life Medical Center Llc | |
|
1579 Falling Leaf Ln Las Vegas NV 89142-1100 | |
| (702) 596-6451 | |
| Not Available |
| Full Name | Great Life Medical Center Llc |
|---|---|
| Speciality | General Practice |
| Location | 1579 Falling Leaf Ln, Las Vegas, Nevada |
| Authorized Official Name and Position | Irosbel Reyes - Blanco (CEO) |
| Authorized Official Contact | 7025966451 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Life Medical Center Llc 1579 Falling Leaf Ln Las Vegas NV 89142-1100 Ph: () - | Great Life Medical Center Llc 1579 Falling Leaf Ln Las Vegas NV 89142-1100 Ph: (702) 596-6451 |
| NPI Number | 1487351854 |
|---|---|
| Provider Enumeration Date | 02/15/2023 |
| Last Update Date | 02/15/2023 |
| Medicare PECOS PAC ID | 3678914603 |
|---|---|
| Medicare Enrollment ID | O20240508002465 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487351854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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