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General NPI Number Information
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NPI Number | 1376195339
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Entity Type | Organization
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Legal Business Name | THE BARIATRIC CENTER, LLC
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Dates
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Enumeration Date | 07/10/2019
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Last Update Date | 07/10/2019
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Provider Practice Location Address
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Address Line | 4560 S EASTERN AVE STE B-14
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City | LAS VEGAS
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State | NV
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Zip | 89119-6182
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Country | US
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Telephone | 702-762-9502
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Fax |
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Provider Business Mailing Address
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Address Line | 3982 SALISBURY PL
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City | LAS VEGAS
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State | NV
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Zip | 89121-4833
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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 | CEO
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Name | ABIGAIL K ANDERSON
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Credential | LCSW
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Telephone | 702-762-9502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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