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NPI Code Detail

MEDICARE: VEGAS HEALTH LLC

MEDICARE: VEGAS HEALTH 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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1538679386
Entity Type Code : Organization
Provider Name (Legal Business Name) : VEGAS HEALTH LLC
Provider Business Mailing Address
First Line : 2604 WHITE OAK RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-5341
Country : US
Telephone Number : 424-227-0823
Fax Number :
Provider Business Practice Location Address
First Line : 2604 WHITE OAK RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-5341
Country : US
Telephone Number : 424-227-0823
Fax Number :
Authorized Official
Title or Position : OWNER
Name : RANDI JEWEL
Credential :
Telephone Number : 424-227-0823
Provider Enumeration Date : 10/06/2017
Last Update Date : 10/06/2017

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Directions to “VEGAS HEALTH LLC ” Practice Location

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