MEDICARE: LIFE GATEWAY

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	103TC2200X	Clinical Child & Adolescent Psychologist		NV

General Provider Information

NPI Number	:	1710246921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE GATEWAY

Provider Business Mailing Address
First Line	:	3605 MOUNTAIN CREST ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7864
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2128 PINK CORAL DR
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-0985
Country	:	US
Telephone Number	:	702-234-9822
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	CYNTHIA EWELL
Credential	:
Telephone Number	:	702-752-9274

Provider Enumeration Date	:	05/08/2012
Last Update Date	:	05/08/2012

Similar Medicare Providers

1740684984 — SUNRIDGE ENTERPRISE INC.
Practice Location Address:

2128 PINK CORAL DR
NORTH LAS VEGAS, NV
89031-0985

Practice Phone: 702-234-9822
Practice Fax:

1205481744 — RASHIRA SHAWAN TAYLOR
Practice Location Address:

2112 PINK CORAL DR
NORTH LAS VEGAS, NV
89031-0985

Practice Phone: 504-292-9536
Practice Fax:

1023965373 — CERA PAIGE LOPEZ NITAFAN
Practice Location Address:

2425 WINDY HILLS AVE
NORTH LAS VEGAS, NV
89031-4358

Practice Phone: 702-201-9678
Practice Fax:

1134877756 — MS. MARICRIS LORRAINE MARZO MSN, APRN, FNP-BC
Practice Location Address:

4755 W ANN RD
NORTH LAS VEGAS, NV
89031-3424

Practice Phone: 702-407-7063
Practice Fax:

1710505508 — KATHERINE JANIS FRANCO PMHNP-BC
Practice Location Address:

450 BRIGHT LIGHTS AVE
NORTH LAS VEGAS, NV
89031-1385

Practice Phone: 702-962-5000
Practice Fax:

1033066311 — JAYDA DIXON
Practice Location Address:

316 POINT LOMA AVE
NORTH LAS VEGAS, NV
89031-7863

Practice Phone: 708-855-3277
Practice Fax:

Directions to “LIFE GATEWAY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.