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General NPI Number Information
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NPI Number | 1093131815
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Entity Type | Organization
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Legal Business Name | NICOLE OKEKE
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Dates
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Enumeration Date | 03/17/2014
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Last Update Date | 03/17/2014
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Provider Practice Location Address
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Address Line | 8304 OLIVE CANYON DR
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City | LAS VEGAS
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State | NV
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Zip | 89128-7960
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Country | US
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Telephone | 702-525-8324
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Fax | 702-749-6332
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Provider Business Mailing Address
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Address Line | 8304 OLIVE CANYON DR
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City | LAS VEGAS
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State | NV
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Zip | 89128-7960
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Country | US
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Telephone | 702-525-8324
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Fax | 702-749-6332
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NICOLE OKEKE
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Credential |
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Telephone | 702-525-8324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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