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2975 S Rainbow Blvd Suite A, & C Las Vegas NV 89146-6242 | |
| (702) 595-2186 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2975 S Rainbow Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Michael Howie (PRESIDENT) |
| Authorized Official Contact | 7025952186 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 571708 Las Vegas NV 89157-1708 Ph: (702) 595-2186 | 2975 S Rainbow Blvd Suite A, & C Las Vegas NV 89146-6242 Ph: (702) 595-2186 |
| NPI Number | 1942672605 |
|---|---|
| Provider Enumeration Date | 10/21/2015 |
| Last Update Date | 01/14/2016 |
| Medicare PECOS PAC ID | 8527364868 |
|---|---|
| Medicare Enrollment ID | O20160311001082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942672605 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Terre Hamrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306884895 PECOS PAC ID: 9335111954 Enrollment ID: I20040812000614 |
| Provider Name | Paul D Wulkan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700887817 PECOS PAC ID: 0042243545 Enrollment ID: I20050915000164 |
| Provider Name | Gina M Morelli |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336435254 PECOS PAC ID: 3375839095 Enrollment ID: I20160907000726 |
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