MEDICARE: COMPREHENSIVE COMMUNITY HEALTH CENTERS - NEVADA INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	213E00000X	Podiatrist
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	1041C0700X	Clinical Social Worker
4	207VX0000X	Obstetrics Physician
5	208000000X	Pediatrics Physician
6	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1144196353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE COMMUNITY HEALTH CENTERS - NEVADA INC

Provider Business Mailing Address
First Line	:	1250 S BUFFALO DR STE 170
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-8329
Country	:	US
Telephone Number	:	818-630-6106
Fax Number	:	818-844-5085

Provider Business Practice Location Address
First Line	:	1250 S BUFFALO DR STE 170
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-8329
Country	:	US
Telephone Number	:	818-630-6106
Fax Number	:	818-844-5085

Authorized Official
Title or Position	:	COO
Name	:	FLORA POLADYAN
Credential	:
Telephone Number	:	818-630-6106

Provider Enumeration Date	:	10/14/2025
Last Update Date	:	10/14/2025

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