Healthcare Provider Details

I. General information

NPI: 1053992891
Provider Name (Legal Business Name): INFINITE OUTLOOK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 04/14/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 W LAKE MEAD BLVD # 9344
LAS VEGAS NV
89128-0297
US

IV. Provider business mailing address

7500 W LAKE MEAD BLVD # 9344
LAS VEGAS NV
89128-0297
US

V. Phone/Fax

Practice location:
  • Phone: 191-398-0247
  • Fax:
Mailing address:
  • Phone: 191-398-0247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CARMEN ROYCE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 913-980-2476