| NPI | 1265198451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA LARA CFO 702-695-0053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| 208000000X Pediatrics | |
| 152W00000X Optometrist | |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 207RR0500X Internal Medicine, Rheumatology | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 213E00000X Podiatrist | |
| 363L00000X Nurse Practitioner | |
| 163WI0500X Registered Nurse, Infusion Therapy | |
| 207Q00000X Family Medicine | |
| 1223G0001X Dentist, General Practice | |
| 163WP0808X Registered Nurse, Psych/Mental Health | |
| 207RI0200X Internal Medicine, Infectious Disease | |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2025-10-16 |