Organization
NLVBH & PRIMARY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRK WAN (CEO)
(702) 469-7897
Entity
Organization
Contact information
Practice address
3277 W CRAIG RD STE 100-130, NORTH LAS VEGAS, NV 89032-0792
(702) 469-7897
Mailing address
3131 W CRAIG RD STE 180, NORTH LAS VEGAS, NV 89032-0861
(702) 469-7897
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2475
—
NV
Enumeration date
08/16/2021
Last updated
08/16/2021
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