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Organization
TCOYL PLUS ONE LLC
Active
Organization
TCOYL PLUS ONE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRENE BENLIRO APRN (MEDICAL DIRECTOR)
(702) 480-8723
Entity
Organization
Contact information
Practice address
11201 S EASTERN AVE STE 110, HENDERSON, NV 89052-6200
(702) 534-4244
(725) 605-6792
Mailing address
11201 S EASTERN AVE STE 110, HENDERSON, NV 89052-6200
(702) 534-4244
(725) 605-6792
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
05/07/2019
Last updated
08/27/2019
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