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General NPI Number Information
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NPI Number | 1063135796
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Entity Type | Organization
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Legal Business Name | ROSEMAN MEDICAL RESEARCH INSTITUTE
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 1 BREAKTHROUGH WAY
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City | LAS VEGAS
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State | NV
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Zip | 89135-3011
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Country | US
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Telephone | 702-802-2851
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Fax |
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Provider Business Mailing Address
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Address Line | 10530 DISCOVERY DR
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City | LAS VEGAS
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State | NV
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Zip | 89135-3050
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Country | US
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Telephone | 702-802-2878
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Fax |
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Authorized Official
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Title or Position | SR. EXE DEAN, FINANCE & OPERATION
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Name | KRISTINA LEE CONNOLLY
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Credential |
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Telephone | 702-802-2878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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