Organization
PRIME HEALTHCARE SERVICES NORTH VISTA LLC
Active
Parent organization
PRIME HEALTHCARE SERVICES NORTH VISTA LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIME HEALTHCARE SERVICES NORTH VISTA LLC
Authorized official
PREM REDDY (CHAIRMAN/PRESIDENT)
(909) 235-4400
Entity
Organization
Contact information
Practice address
1409 E LAKE MEAD BLVD, NORTH LAS VEGAS, NV 89030-7120
(702) 649-7711
Mailing address
1409 E LAKE MEAD BLVD, NORTH LAS VEGAS, NV 89030-7120
(702) 649-7711
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
649HOS-34
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100502299
—
NV
05
—
100502300
—
NV
05
—
100502301
—
NV
Enumeration date
12/05/2014
Last updated
12/05/2014
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