MEDICARE: VEGAS HEALTH INC

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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1366966806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VEGAS HEALTH INC

Provider Business Mailing Address
First Line	:	2604 WHITE OAK RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-5341
Country	:	US
Telephone Number	:	702-205-7515
Fax Number	:

Provider Business Practice Location Address
First Line	:	2604 WHITE OAK RD
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-5341
Country	:	US
Telephone Number	:	702-205-7515
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	J SMITH
Credential	:
Telephone Number	:	702-351-8877

Provider Enumeration Date	:	07/26/2017
Last Update Date	:	07/21/2022

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