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NPI Code Detail

MEDICARE: HALO HEALTH SUMMERLIN LLC

MEDICARE: HALO HEALTH SUMMERLIN LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1194616342
Entity Type Code : Organization
Provider Name (Legal Business Name) : HALO HEALTH SUMMERLIN LLC
Provider Business Mailing Address
First Line : 1707 VILLAGE CENTER CIR STE 250
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-0597
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1707 VILLAGE CENTER CIR STE 250
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-0597
Country : US
Telephone Number : 702-718-7353
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : PAUL MANLEY
Credential :
Telephone Number : 520-370-7944
Provider Enumeration Date : 07/14/2025
Last Update Date : 07/18/2025

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Directions to “HALO HEALTH SUMMERLIN LLC ” Practice Location

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