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NPI Code Detail

MEDICARE: CITY OF LAS VEGAS

MEDICARE: CITY OF LAS VEGAS
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
1101YM0800XMental Health Counselor
2208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1184216970
Entity Type Code : Organization
Provider Name (Legal Business Name) : CITY OF LAS VEGAS
Provider Business Mailing Address
First Line : 495 S MAIN ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-6318
Country : US
Telephone Number : 702-229-6906
Fax Number :
Provider Business Practice Location Address
First Line : 314 FOREMASTER LN
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-1008
Country : US
Telephone Number : 702-229-2484
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : MAURICE CLOUTIER
Credential :
Telephone Number : 702-229-2485
Provider Enumeration Date : 02/03/2021
Last Update Date : 07/15/2024

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Directions to “CITY OF LAS VEGAS ” Practice Location

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