Healthcare Provider Details

I. General information

NPI: 1891585071
Provider Name (Legal Business Name): SAMSARA ADDE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 S EASTERN AVE STE 203A
LAS VEGAS NV
89119-6139
US

IV. Provider business mailing address

83 PARKER RANCH DR
HENDERSON NV
89012-2613
US

V. Phone/Fax

Practice location:
  • Phone: 702-713-4501
  • Fax:
Mailing address:
  • Phone: 702-713-4501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HECTOR GEOVANI PEREZ MARTINEZ
Title or Position: MANAGER
Credential:
Phone: 702-713-4501