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General NPI Number Information
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NPI Number | 1730992967
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Entity Type | Organization
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Legal Business Name | EMPOWERMENT CENTER OF SOUTHERN NEVADA LLC
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 1024 W OWENS AVE STE B
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City | LAS VEGAS
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State | NV
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Zip | 89106-2520
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Country | US
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Telephone | 702-636-8729
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Fax | 702-441-1808
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Provider Business Mailing Address
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Address Line | 1024 W OWENS AVE STE B
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City | LAS VEGAS
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State | NV
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Zip | 89106-2520
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Country | US
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Telephone | 702-636-8729
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Fax | 702-441-1808
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Authorized Official
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Title or Position | OWNER
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Name | JOHNA GAUFF
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Credential |
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Telephone | 702-721-8505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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