Organization
ELEVATED BRAIN TECHS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOUIE DANIEL TAQUIQUI (OWNER)
(702) 806-5198
Entity
Organization
Contact information
Practice address
2915 CEDAR AVE UNIT 4D, LAS VEGAS, NV 89101-3831
(702) 806-5198
Mailing address
3566 TUNDRA SWAN ST, LAS VEGAS, NV 89122-3501
(702) 806-5198
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
NV20171436936
NV
Other
Enumeration date
11/02/2017
Last updated
11/02/2017
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