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General NPI Number Information
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NPI Number | 1063891182
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Entity Type | Organization
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Legal Business Name | NEVADA HEALTH CENTERS INC
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Dates
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Enumeration Date | 05/21/2015
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Last Update Date | 06/20/2016
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Provider Practice Location Address
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Address Line | 98 E LAKE MEAD PKWY SUITE 103
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City | HENDERSON
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State | NV
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Zip | 89015-5540
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Country | US
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Telephone | 702-868-0327
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Fax | 702-868-0290
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Provider Business Mailing Address
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Address Line | 3325 RESEARCH WAY
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City | CARSON CITY
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State | NV
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Zip | 89706-7913
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Country | US
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Telephone | 775-888-6610
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Fax | 775-888-4904
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | WALTER B DAVIS
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Credential |
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Telephone | 775-888-6610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | H80-015005
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License Number State | NV
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