Organization
ESSENTIAL CLINIC LLC
Active
Other names
Essential Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
WALLY JOSEPH NP (OWNER)
(725) 241-5252
Entity
Organization
Contact information
Practice address
600 W SUNSET RD STE 102, HENDERSON, NV 89011-4112
(000) 000-0000
Mailing address
600 W SUNSET RD STE 102, HENDERSON, NV 89011-4112
(725) 241-5252
(725) 241-7474
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326595125
FAMILY NURSE PRACTITIONER AND PSYCHIATRIC NURSE PRACTITIONER
CA
Enumeration date
04/20/2021
Last updated
06/08/2024
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