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3230 E Charleston Blvd Suite 111 Las Vegas NV 89104-6626 | |
| (775) 267-9411 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3230 E Charleston Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Lawrence W Howell (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7752679411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2560 Business Pkwy Suite A Minden NV 89423-8931 Ph: (775) 267-9411 | 3230 E Charleston Blvd Suite 111 Las Vegas NV 89104-6626 Ph: (775) 267-9411 |
| NPI Number | 1790862357 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790862357 | NPI | - | NPPES |
| 100509752 | Medicaid | NV | |
| 100509750 | Medicaid | NV | |
| 100509753 | Medicaid | NV | |
| 100509748 | Medicaid | NV | |
| 100509749 | Medicaid | NV | |
| 100509751 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (Nevada) | Primary |
| 171M00000X | Case Manager/care Coordinator | (Nevada) | Secondary |
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