MEDICARE: MOE'NIQUE LOVE

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	251S00000X	Community/Behavioral Health Agency		NV

General Provider Information

NPI Number	:	1154252963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOE'NIQUE LOVE

Provider Business Mailing Address
First Line	:	2905 BIG MOUNTAIN AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89081-6428
Country	:	US
Telephone Number	:	725-777-8505
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 N RAINBOW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-1189
Country	:	US
Telephone Number	:	725-227-3716
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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Directions to “ MOE'NIQUE LOVE ” Practice Location

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