Healthcare Provider Details

I. General information

NPI: 1043741002
Provider Name (Legal Business Name): VMAE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 03/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5276 DAKOTAH POINTE CT
NORTH LAS VEGAS NV
89031-3411
US

IV. Provider business mailing address

2701 N RAINBOW BLVD APT 2149
LAS VEGAS NV
89108-7109
US

V. Phone/Fax

Practice location:
  • Phone: 702-506-7846
  • Fax:
Mailing address:
  • Phone: 702-772-6652
  • 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: MS. YAMINA KHAMEELAH JONES
Title or Position: SECRETARY
Credential:
Phone: 702-772-6652