Provider Demographics
NPI:1407219611
Name:FIRST PERSON CARE CLINIC
Entity Type:Organization
Organization Name:FIRST PERSON CARE CLINIC
Other - Org Name:HUNTRIDGE TEEN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROXANA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-380-8118
Mailing Address - Street 1:2100 S MARYLAND PKWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3230
Mailing Address - Country:US
Mailing Address - Phone:702-732-8776
Mailing Address - Fax:702-369-2162
Practice Address - Street 1:2100 S MARYLAND PKWY
Practice Address - Street 2:SUITE 1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3230
Practice Address - Country:US
Practice Address - Phone:702-732-8776
Practice Address - Fax:702-369-2162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-04
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public HealthGroup - Multi-Specialty
No364SP0810XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & FamilyGroup - Multi-Specialty