MEDICARE: THE DANDELION 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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1801772132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE DANDELION LLC

Provider Business Mailing Address
First Line	:	3562 HUERTA DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-2910
Country	:	US
Telephone Number	:	725-272-9217
Fax Number	:

Provider Business Practice Location Address
First Line	:	3562 HUERTA DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-2910
Country	:	US
Telephone Number	:	725-272-9217
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	CAROLYN CARTER
Credential	:
Telephone Number	:	725-272-9217

Provider Enumeration Date	:	08/13/2025
Last Update Date	:	08/17/2025

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Directions to “THE DANDELION LLC ” Practice Location

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