Healthcare Provider Details

I. General information

NPI: 1497833768
Provider Name (Legal Business Name): NEVADA HEALTH CENTERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 LADY LUCK DRIVE BOX 628
JACKPOT NV
89825-0628
US

IV. Provider business mailing address

3325 RESEARCH WAY
CARSON CITY NV
89706-7913
US

V. Phone/Fax

Practice location:
  • Phone: 775-755-2500
  • Fax: 775-755-2502
Mailing address:
  • Phone: 775-888-6610
  • Fax: 775-888-4904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNV

VIII. Authorized Official

Name: WALTER B DAVIS
Title or Position: CEO
Credential:
Phone: 775-888-6610