Healthcare Provider Details

I. General information

NPI: 1629819180
Provider Name (Legal Business Name): URBANE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2024
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6709 COURTNEY MICHELLE ST
N LAS VEGAS NV
89086-1391
US

IV. Provider business mailing address

6709 COURTNEY MICHELLE ST
N LAS VEGAS NV
89086-1391
US

V. Phone/Fax

Practice location:
  • Phone: 702-666-3361
  • Fax:
Mailing address:
  • Phone: 702-666-3361
  • 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: DEANNA D DORSEY
Title or Position: MEMBER
Credential:
Phone: 702-666-3361