Provider Demographics
NPI:1144772393
Name:ALVARADO LOPEZ
Entity Type:Organization
Organization Name:ALVARADO LOPEZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH SERVICE PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:787-486-6111
Mailing Address - Street 1:818 E FLAMINGO RD
Mailing Address - Street 2:#205
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-7315
Mailing Address - Country:US
Mailing Address - Phone:787-486-6111
Mailing Address - Fax:
Practice Address - Street 1:818 E FLAMINGO RD
Practice Address - Street 2:#205
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7315
Practice Address - Country:US
Practice Address - Phone:787-486-6111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health