=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952212169
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LET WELLNESS PREVAIL CARE CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2026
-----------------------------------------------------
Last Update Date | 09/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6021 FIDDLER RIDGE TRL UNIT 103
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89011-1427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-475-2591
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6021 FIDDLER RIDGE TRL UNIT 103
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89011-1427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-279-0115
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | LEMARCUS ANDERSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 702-475-2591
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------