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General NPI Number Information
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NPI Number | 1194616342
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Entity Type | Organization
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Legal Business Name | HALO HEALTH SUMMERLIN LLC
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 1707 VILLAGE CENTER CIR STE 250
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City | LAS VEGAS
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State | NV
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Zip | 89134-0597
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Country | US
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Telephone | 702-718-7353
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Fax |
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Provider Business Mailing Address
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Address Line | 1707 VILLAGE CENTER CIR STE 250
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City | LAS VEGAS
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State | NV
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Zip | 89134-0597
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | PAUL MANLEY
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Credential |
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Telephone | 520-370-7944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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