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Provider details

NPI number
Authorized official
ASHLEY ALFRED MEZA (CEO)
(702) 913-5766
Entity
Organization

Contact information

Practice address
2870 S MARYLAND PKWY STE 150, LAS VEGAS, NV 89109-5016
(702) 331-3517
Mailing address
2870 S MARYLAND PKWY STE 150, LAS VEGAS, NV 89109-5016
(702) 331-3517
(702) 903-3564

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Enumeration date
07/22/2021
Last updated
07/16/2024
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