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General NPI Number Information
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NPI Number | 1831824481
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Entity Type | Organization
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Legal Business Name | HEALTHCARE CONNECT 360, LLC
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 6671 S. LAS VEGAS BLVD SUITE#210
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City | LAS VEGAS
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State | NV
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Zip | 89119
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Country | US
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Telephone | 847-345-2441
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Fax | 847-474-9263
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Provider Business Mailing Address
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Address Line | 6671 S. LAS VEGAS BLVD SUITE#210
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City | LAS VEGAS
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State | NV
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Zip | 89119
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Country | US
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Telephone | 847-345-2441
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Fax | 847-474-9263
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Authorized Official
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Title or Position | CMO
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Name | ANTHONY QUESADA
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Credential |
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Telephone | 847-644-9317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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