Healthcare Provider Details

I. General information

NPI: 1457849077
Provider Name (Legal Business Name): HEALTHCARE PLUS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2018
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4723 E FLAMINGO RD
LAS VEGAS NV
89121-4742
US

IV. Provider business mailing address

4718 E FLAMINGO RD
LAS VEGAS NV
89121-4709
US

V. Phone/Fax

Practice location:
  • Phone: 702-448-3332
  • Fax: 702-902-5401
Mailing address:
  • Phone: 702-902-5400
  • Fax: 702-902-5401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: COSMAS EZE
Title or Position: MANAGING EMPLOYEE
Credential: THERAPIST
Phone: 702-448-3332