| NPI | 1841182821 |
|---|---|
| Doing Business As | LAS VEGAS NV - E LAKE MEAD - RED |
| Entity Type | Organization |
| Authorized Contact | KARLA SPIVEY Central Support Specialist 317-869-3164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2025-07-16 |
| Last Update Date | 2025-07-16 |