Individual
MR. CHARLES BALICAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4180 S PECOS RD, LAS VEGAS, NV 89121-5074
(702) 486-7538
Mailing address
4180 S PECOS RD, LAS VEGAS, NV 89121-5074
(702) 486-7538
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
04/28/2012
Last updated
06/03/2015
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