Provider Demographics
NPI:1174044861
Name:SEARCHLIGHT HEALTHCARE CHARITIES
Entity Type:Organization
Organization Name:SEARCHLIGHT HEALTHCARE CHARITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-478-8070
Mailing Address - Street 1:98 E LAKE MEAD PKWY STE 305
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-6444
Mailing Address - Country:US
Mailing Address - Phone:702-478-8070
Mailing Address - Fax:
Practice Address - Street 1:98 E LAKE MEAD PKWY STE 305
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-6444
Practice Address - Country:US
Practice Address - Phone:702-478-8070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV261QF0400X207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1598106049Medicaid