| Victory Alliance Llc | |
|
222 S Rainbow Blvd Ste 107 Las Vegas NV 89145-5343 | |
| (702) 912-5404 | |
| (702) 786-6911 |
| Full Name | Victory Alliance Llc |
|---|---|
| Speciality | Social Worker |
| Location | 222 S Rainbow Blvd Ste 107, Las Vegas, Nevada |
| Authorized Official Name and Position | Alexandra Laplante (OWNER) |
| Authorized Official Contact | 7023786092 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Victory Alliance Llc 222 S Rainbow Blvd Ste 107 Las Vegas NV 89145-5343 Ph: (702) 912-5404 | Victory Alliance Llc 222 S Rainbow Blvd Ste 107 Las Vegas NV 89145-5343 Ph: (702) 912-5404 |
| NPI Number | 1790158475 |
|---|---|
| Provider Enumeration Date | 11/04/2015 |
| Last Update Date | 07/29/2021 |
| Certification Date | 07/29/2021 |
| Medicare PECOS PAC ID | 6406120872 |
|---|---|
| Medicare Enrollment ID | O20170922003457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790158475 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Alexandra Renee Laplante |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376774711 PECOS PAC ID: 2264798313 Enrollment ID: I20180621002429 |
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