Organization
DESERT PAIN & WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE LADUCA (CREDENTIALING MANAGER)
(845) 702-2711
Entity
Organization
Contact information
Practice address
2000 S EASTERN AVE # C, LAS VEGAS, NV 89104-4100
(725) 251-5308
Mailing address
2000 S EASTERN AVE # C, LAS VEGAS, NV 89104-4100
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
09/30/2024
Last updated
03/17/2025
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