MEDICARE: SEARCHLIGHT HEALTHCARE CHARITIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033630710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEARCHLIGHT HEALTHCARE CHARITIES

Provider Business Mailing Address
First Line	:	98 E LAKE MEAD PKWY STE 305
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-6444
Country	:	US
Telephone Number	:	702-478-8070
Fax Number	:

Provider Business Practice Location Address
First Line	:	98 E LAKE MEAD PKWY STE 305
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89015-6444
Country	:	US
Telephone Number	:	702-478-8070
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF CLINIC OPERATIONS
Name	:	DAVID KAHANANUI
Credential	:
Telephone Number	:	702-478-8070

Provider Enumeration Date	:	07/03/2017
Last Update Date	:	07/21/2022

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