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General NPI Number Information
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NPI Number | 1477052959
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Entity Type | Organization
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Legal Business Name | LV ELITE CARE SERVICES LLC
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Dates
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Enumeration Date | 02/09/2018
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Last Update Date | 02/09/2018
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Provider Practice Location Address
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Address Line | 7951 W CHARELSTON BLVD #30
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City | LAS VEGAS
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State | NV
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Zip | 89117
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Country | US
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Telephone | 702-238-5949
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Fax |
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Provider Business Mailing Address
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Address Line | 7951 W CHARELSTON BLVD #30
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City | LAS VEGAS
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State | NV
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Zip | 89117
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Country | US
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Telephone | 702-238-5949
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Fax |
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Authorized Official
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Title or Position | CONTRACTED
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Name | VENESA L HINES
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Credential |
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Telephone | 210-683-9747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | NV20181100355
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License Number State | NV
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