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General NPI Number Information
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NPI Number | 1427829167
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Entity Type | Organization
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Legal Business Name | VEGAS VALLEY WHOLE HEALTH
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 6655 S TENAYA WAY STE 180
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City | LAS VEGAS
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State | NV
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Zip | 89113-1929
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Country | US
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Telephone | 702-463-7611
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Fax |
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Provider Business Mailing Address
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Address Line | 6655 S TENAYA WAY STE 180
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City | LAS VEGAS
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State | NV
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Zip | 89113-1929
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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 | PRESIDENT
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Name | MARSHALL T MORROW
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Credential |
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Telephone | 702-463-7611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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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 | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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