Provider Demographics
NPI:1497820500
Name:NEVADA HEALTH CENTERS, INC.
Entity Type:Organization
Organization Name:NEVADA HEALTH CENTERS, INC.
Other - Org Name:NORTH LAS VEGAS FAMILY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-888-6610
Mailing Address - Street 1:3325 RESEARCH WAY
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-7913
Mailing Address - Country:US
Mailing Address - Phone:775-888-6610
Mailing Address - Fax:775-888-4904
Practice Address - Street 1:2225 CIVIC CENTER DR
Practice Address - Street 2:SUITE 224
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-6328
Practice Address - Country:US
Practice Address - Phone:702-214-5948
Practice Address - Fax:702-214-9439
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEVADA HEALTH CENTERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1497820500Medicaid
NVDQ468AOtherMEDICARE ID - TYPE UNSPECIFIED
NV291824Medicare Oscar/Certification