Healthcare Provider Details

I. General information

NPI: 1336028885
Provider Name (Legal Business Name): PANOPTIC HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2575 MONTESSOURI ST STE 200
LAS VEGAS NV
89117-3060
US

IV. Provider business mailing address

2575 MONTESSOURI ST STE 200
LAS VEGAS NV
89117-3060
US

V. Phone/Fax

Practice location:
  • Phone: 520-277-8252
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LEE SYKES
Title or Position: CEO
Credential:
Phone: 520-277-8252