Organization
PRIMECARE FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEFINA R ADAMS (OWNER/ADMINISTRATOR)
(702) 203-2381
Entity
Organization
Contact information
Practice address
4920 RONAN DR, LAS VEGAS, NV 89110-4736
(702) 203-2381
Mailing address
4920 RONAN DR, LAS VEGAS, NV 89110
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
NB20101850035
NV
Other
Enumeration date
01/26/2011
Last updated
01/26/2011
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