Healthcare Provider Details

I. General information

NPI: 1285185280
Provider Name (Legal Business Name): REHAB DIRECTIVES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2016
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3213 W CHARLESTON BLVD STE 101
LAS VEGAS NV
89102-1991
US

IV. Provider business mailing address

3213 W CHARLESTON BLVD STE 101
LAS VEGAS NV
89102-1991
US

V. Phone/Fax

Practice location:
  • Phone: 702-570-6222
  • Fax: 702-570-6234
Mailing address:
  • Phone: 702-570-6222
  • Fax: 702-570-6234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: DAVID GILBERT
Title or Position: GENERAL MANAGER
Credential: LMT
Phone: 702-570-6222