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General NPI Number Information
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NPI Number | 1386055028
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Entity Type | Organization
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Legal Business Name | DR. JOEL & CAROL BOWER SCHOOL BASED HEALTH CENTER
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Dates
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Enumeration Date | 05/15/2014
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Last Update Date | 05/20/2014
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Provider Practice Location Address
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Address Line | 400 PALO VERDE DR
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City | HENDERSON
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State | NV
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Zip | 89015-6028
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Country | US
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Telephone | 702-799-0508
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Fax | 702-799-0510
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Provider Business Mailing Address
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Address Line | 400 PALO VERDE DR
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City | HENDERSON
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State | NV
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Zip | 89015-6028
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Country | US
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Telephone | 702-799-0508
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Fax | 702-799-0510
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SHERRILYN COFFMAN
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Credential |
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Telephone | 702-992-2045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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