MEDICARE: BATTLE HEALTH & WELLNESS CENTER LLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1194347385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BATTLE HEALTH & WELLNESS CENTER LLC

Provider Business Mailing Address
First Line	:	2418 GRAND PRIZE AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-3599
Country	:	US
Telephone Number	:	702-670-8868
Fax Number	:

Provider Business Practice Location Address
First Line	:	2418 GRAND PRIZE AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-3599
Country	:	US
Telephone Number	:	702-670-8868
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ADELE MCCLENDON
Credential	:
Telephone Number	:	702-670-8868

Provider Enumeration Date	:	05/11/2020
Last Update Date	:	05/12/2020

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