Healthcare Provider Details

I. General information

NPI: 1811717168
Provider Name (Legal Business Name): CULTIVATING COMMUNITIES TOGETHER HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 FIRE MESA ST STE 130
LAS VEGAS NV
89128-9009
US

IV. Provider business mailing address

8379 W SUNSET RD STE 210
LAS VEGAS NV
89113-2243
US

V. Phone/Fax

Practice location:
  • Phone: 843-814-5177
  • Fax:
Mailing address:
  • Phone: 843-814-5177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RAJ SONANI
Title or Position: MANAGER
Credential:
Phone: 678-989-8942