| Salute Healthcare Center Llc | |
|
5604 Harmony Ave Las Vegas NV 89107-2625 | |
| (702) 910-0300 | |
| Not Available |
| Full Name | Salute Healthcare Center Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5604 Harmony Ave, Las Vegas, Nevada |
| Authorized Official Name and Position | Elizabeth Acosta (MANAGING MEMBER) |
| Authorized Official Contact | 7029100300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Salute Healthcare Center Llc 5604 Harmony Ave Las Vegas NV 89107-2625 Ph: (702) 910-0300 | Salute Healthcare Center Llc 5604 Harmony Ave Las Vegas NV 89107-2625 Ph: (702) 910-0300 |
| NPI Number | 1043889942 |
|---|---|
| Provider Enumeration Date | 06/23/2021 |
| Last Update Date | 06/23/2021 |
| Certification Date | 06/23/2021 |
| Medicare PECOS PAC ID | 7618369562 |
|---|---|
| Medicare Enrollment ID | O20220126002058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043889942 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Martin D Fakiel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972787000 PECOS PAC ID: 1254319544 Enrollment ID: I20040713000226 |
| Provider Name | Lili S Lero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821425596 PECOS PAC ID: 8527288968 Enrollment ID: I20141006002352 |
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