Organization
GENESIS VIDA HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENYATTA FLETCHER (OWNER)
(702) 472-6231
Entity
Organization
Contact information
Practice address
6075 SILKEN SADDLE ST, NORTH LAS VEGAS, NV 89031-6854
(702) 472-6231
Mailing address
4412 EL PARQUE AVE, LAS VEGAS, NV 89102-3502
(702) 472-6231
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/11/2018
Last updated
10/09/2020
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