Healthcare Provider Details

I. General information

NPI: 1760251144
Provider Name (Legal Business Name): MEKENI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2023
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5625 LOSEE RD
NORTH LAS VEGAS NV
89081-2523
US

IV. Provider business mailing address

PO BOX 33789
LAS VEGAS NV
89133-3789
US

V. Phone/Fax

Practice location:
  • Phone: 702-688-2507
  • Fax:
Mailing address:
  • Phone: 702-688-2507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: GINA BALGOYEN
Title or Position: DIRECTOR
Credential: APRN
Phone: 702-688-2507