Healthcare Provider Details

I. General information

NPI: 1750103420
Provider Name (Legal Business Name): HALO HEALTH GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2024
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 SHADOW LN STE 207
LAS VEGAS NV
89106-4358
US

IV. Provider business mailing address

400 SHADOW LN STE 207
LAS VEGAS NV
89106-4358
US

V. Phone/Fax

Practice location:
  • Phone: 702-718-7353
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: PAUL MANLEY
Title or Position: DIRECTOR
Credential:
Phone: 520-370-7944