Healthcare Provider Details

I. General information

NPI: 1295277630
Provider Name (Legal Business Name): VMAE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2016
Last Update Date: 03/27/2023
Certification Date: 03/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5715 W ALEXANDER RD STE 110A
LAS VEGAS NV
89130-2815
US

IV. Provider business mailing address

5715 W ALEXANDER RD STE 110A
LAS VEGAS NV
89130-2815
US

V. Phone/Fax

Practice location:
  • Phone: 702-333-4373
  • Fax: 702-333-4337
Mailing address:
  • Phone: 702-333-4373
  • Fax: 702-333-4337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VIRGINIA M KENDRID
Title or Position: CEO
Credential:
Phone: 725-237-1300