MEDICARE: FAMILY HEALTH CLINIC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QA3000X	Augmentative Communication Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center
3	261QM2500X	Medical Specialty Clinic/Center
4	261QP2300X	Primary Care Clinic/Center
5	363LP2300X	Primary Care Nurse Practitioner
6	261QM1300X	Multi-Specialty Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407656374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY HEALTH CLINIC

Provider Business Mailing Address
First Line	:	6330 W FLAMINGO RD UNIT 106
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-2234
Country	:	US
Telephone Number	:	702-918-2800
Fax Number	:	702-947-5352

Provider Business Practice Location Address
First Line	:	6330 W FLAMINGO RD UNIT 106
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-2234
Country	:	US
Telephone Number	:	702-918-2800
Fax Number	:	702-947-5352

Authorized Official
Title or Position	:	OWNER
Name	:	REYNANTE VILLAHERMOSA
Credential	:
Telephone Number	:	702-885-6457

Provider Enumeration Date	:	03/18/2025
Last Update Date	:	03/18/2025

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Directions to “FAMILY HEALTH CLINIC ” Practice Location

Language	Start Address	Practice Location

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