Healthcare Provider Details

I. General information

NPI: 1063282986
Provider Name (Legal Business Name): CLAY HEALTH & CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2024
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8180 RAFAEL RIVERA WAY
LAS VEGAS NV
89113-5409
US

IV. Provider business mailing address

8180 RAFAEL RIVERA WAY
LAS VEGAS NV
89113-5409
US

V. Phone/Fax

Practice location:
  • Phone: 702-840-3722
  • Fax: 833-450-5718
Mailing address:
  • Phone: 702-840-3722
  • Fax: 833-450-5718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAUREL RIS
Title or Position: COO
Credential:
Phone: 702-840-3722