Healthcare Provider Details

I. General information

NPI: 1649086885
Provider Name (Legal Business Name): F.A.M HEALING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2024
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 E CALVADA BLVD STE 5A
PAHRUMP NV
89048-5821
US

IV. Provider business mailing address

4108 CAROL BAILEY AVE
NORTH LAS VEGAS NV
89081-6809
US

V. Phone/Fax

Practice location:
  • Phone: 725-525-1024
  • Fax:
Mailing address:
  • Phone: 702-472-3137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. BEATRICE MARQUEZ
Title or Position: OWNER
Credential: MFT-I, LADC
Phone: 702-472-3137