| Wholistic Recovery Llc | |
|
1881 Stevens St Las Vegas NV 89115-6312 | |
| (702) 525-7918 | |
| Not Available |
| Full Name | Wholistic Recovery Llc |
|---|---|
| Speciality | Counselor |
| Location | 1881 Stevens St, Las Vegas, Nevada |
| Authorized Official Name and Position | Ojoma Okotie Brothers (MANAGER) |
| Authorized Official Contact | 7025257918 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wholistic Recovery Llc 1881 Stevens St Las Vegas NV 89115-6312 Ph: (702) 525-7918 | Wholistic Recovery Llc 1881 Stevens St Las Vegas NV 89115-6312 Ph: (702) 525-7918 |
| NPI Number | 1669241535 |
|---|---|
| Provider Enumeration Date | 12/20/2023 |
| Last Update Date | 11/06/2024 |
| Certification Date | 11/06/2024 |
| Medicare PECOS PAC ID | 5496280240 |
|---|---|
| Medicare Enrollment ID | O20241203001481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669241535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Maricel Olan-cabrera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659617850 PECOS PAC ID: 2163653007 Enrollment ID: I20140318001757 |
| Provider Name | Raymond F O'brien |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144472770 PECOS PAC ID: 6002245693 Enrollment ID: I20200402001112 |
| Provider Name | Armando Javier Brito |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124725858 PECOS PAC ID: 5193173979 Enrollment ID: I20231205001491 |
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