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801 S Rancho Dr Ste C3 Las Vegas NV 89106-3858 | |
| (702) 385-2153 | |
| (702) 385-7659 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 801 S Rancho Dr Ste C3, Las Vegas, Nevada |
| Authorized Official Name and Position | Cheryl Elizabeth Carrasco (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7023852153 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
801 S Rancho Dr Ste C3 Las Vegas NV 89106-3858 Ph: (702) 385-2153 | 801 S Rancho Dr Ste C3 Las Vegas NV 89106-3858 Ph: (702) 385-2153 |
| NPI Number | 1730485210 |
|---|---|
| Provider Enumeration Date | 02/01/2011 |
| Last Update Date | 07/18/2023 |
| Certification Date | 07/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730485210 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 0654 (Nevada) | Primary |
| 251B00000X | Case Management | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
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