Individual
IVAN RIVAS LAMBAREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2350 S JONES BLVD, LAS VEGAS, NV 89146-3103
(702) 214-2193
Mailing address
3295 N NELLIS BLVD TRLR 63, LAS VEGAS, NV 89115-3048
(702) 496-5518
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/23/2018
Last updated
02/23/2018
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