# ROSEMAN MEDICAL RESEARCH INSTITUTE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ROSEMAN ROSEMAN MEDICAL RESEARCH INSTITUTE
- **Other names:** Roseman Medical Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063135796
- **Legal business name:** ROSEMAN ROSEMAN MEDICAL RESEARCH INSTITUTE
- **Authorized official:** KRISTINA LEE CONNOLLY (SR. EXE DEAN, FINANCE & OPERATION)
- **Authorized official phone:** (702) 802-2878

## Contact information

- **Practice address:** 1 BREAKTHROUGH WAY, LAS VEGAS, NV 89135-3011
- **Practice address phone:** (702) 802-2851
- **Mailing address:** 10530 DISCOVERY DR, LAS VEGAS, NV 89135-3050
- **Mailing address phone:** (702) 802-2878

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | NULL | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 175T00000X | Peer Specialist | — | NULL | — |
| 175T00000X | Peer Specialist | — | — | — |

## Other

- **Enumeration date:** 09/19/2022
- **Last updated:** 09/19/2022