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NPI Code Detail

MEDICARE: RED ROCK GUIDANCE & WELLNESS CENTER

MEDICARE: RED ROCK GUIDANCE & WELLNESS CENTER
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
1251S00000XCommunity/Behavioral Health Agency0936NV

General Provider Information

NPI Number : 1083869663
Entity Type Code : Organization
Provider Name (Legal Business Name) : RED ROCK GUIDANCE & WELLNESS CENTER
Provider Business Mailing Address
First Line : 2580 MONTESSOURI STREET
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-3065
Country : US
Telephone Number : 702-947-4749
Fax Number : 702-256-2295
Provider Business Practice Location Address
First Line : 2580 MONTESSOURI STREET
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-3065
Country : US
Telephone Number : 702-947-4749
Fax Number : 702-256-2295
Authorized Official
Title or Position : CEO
Name : DR. YOLANDA TREVINO
Credential : PH.D.
Telephone Number : 702-947-4749
Provider Enumeration Date : 11/24/2008
Last Update Date : 11/24/2008

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Directions to “RED ROCK GUIDANCE & WELLNESS CENTER ” Practice Location

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