Healthcare Provider Details

I. General information

NPI: 1962227454
Provider Name (Legal Business Name): ENLIVEN INFUSION AND WELLNESS CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 FALCON RIDGE PKWY STE 204
MESQUITE NV
89027-8879
US

IV. Provider business mailing address

350 FALCON RIDGE PKWY STE 204
MESQUITE NV
89027-8879
US

V. Phone/Fax

Practice location:
  • Phone: 702-686-8907
  • Fax:
Mailing address:
  • Phone: 702-686-8907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RODNEY JOSEPH BRIGGS
Title or Position: OWNER
Credential: PA
Phone: 702-686-8907