MEDICARE: GREATER LAS VEGAS VETERANS RESOUCE CENTER

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1902766751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER LAS VEGAS VETERANS RESOUCE CENTER

Provider Business Mailing Address
First Line	:	304 S JONES BLVD STE 8834
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-2623
Country	:	US
Telephone Number	:	725-346-6528
Fax Number	:	725-346-6528

Provider Business Practice Location Address
First Line	:	212 ALEXANDER AVE STE 8834
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-2626
Country	:	US
Telephone Number	:	725-326-3536
Fax Number	:

Authorized Official
Title or Position	:	PASTORAL COUNSELOR
Name	:	STEPHEN R LACEY
Credential	:	D.DIV.
Telephone Number	:	725-346-6528

Provider Enumeration Date	:	11/14/2025
Last Update Date	:	11/14/2025

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