Healthcare Provider Details

I. General information

NPI: 1801763941
Provider Name (Legal Business Name): TRUE NORTH HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7495 W AZURE DR STE 256
LAS VEGAS NV
89130-4417
US

IV. Provider business mailing address

7495 W AZURE DR STE 256
LAS VEGAS NV
89130-4417
US

V. Phone/Fax

Practice location:
  • Phone: 323-803-3921
  • Fax:
Mailing address:
  • Phone: 323-803-3921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SIMONA BOCCUTO
Title or Position: OWNER
Credential: CEO
Phone: 323-803-3921