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General NPI Number Information
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NPI Number | 1407656374
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH CLINIC
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 6330 W FLAMINGO RD UNIT 106
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City | LAS VEGAS
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State | NV
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Zip | 89103-2234
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Country | US
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Telephone | 702-918-2800
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Fax | 702-947-5352
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Provider Business Mailing Address
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Address Line | 6330 W FLAMINGO RD UNIT 106
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City | LAS VEGAS
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State | NV
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Zip | 89103-2234
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Country | US
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Telephone | 702-918-2800
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Fax | 702-947-5352
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Authorized Official
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Title or Position | OWNER
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Name | REYNANTE VILLAHERMOSA
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Credential |
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Telephone | 702-885-6457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA3000X
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Taxonomy Name | Augmentative Communication Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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