Provider Demographics
NPI:1477237576
Name:NEVADA COMMUNITY HEALTH WORKERS LLC
Entity Type:Organization
Organization Name:NEVADA COMMUNITY HEALTH WORKERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROCIO
Authorized Official - Middle Name:
Authorized Official - Last Name:FAVELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-480-6024
Mailing Address - Street 1:4323 HONEYCOMB DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-4922
Mailing Address - Country:US
Mailing Address - Phone:702-480-6024
Mailing Address - Fax:
Practice Address - Street 1:546 N EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-3481
Practice Address - Country:US
Practice Address - Phone:702-480-6024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty