Healthcare Provider Details

I. General information

NPI: 1023736600
Provider Name (Legal Business Name): NEIGHBORHOOD CLINIC NV LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2022
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 W ANN RD
NORTH LAS VEGAS NV
89031-3847
US

IV. Provider business mailing address

8488 ROZITA LEE AVE STE 100
LAS VEGAS NV
89113-4772
US

V. Phone/Fax

Practice location:
  • Phone: 702-208-9408
  • Fax:
Mailing address:
  • Phone: 702-425-8105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TRENT HOFMOCKEL
Title or Position: PRESIDENT
Credential:
Phone: 702-425-8105