Provider Demographics
NPI:1609285014
Name:THE GATEWAY CENTER LAS VEGAS, LLC
Entity Type:Organization
Organization Name:THE GATEWAY CENTER LAS VEGAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HUMAN RESOURCES
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:MILNE
Authorized Official - Last Name:STILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-420-0919
Mailing Address - Street 1:74 N PECOS RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7343
Mailing Address - Country:US
Mailing Address - Phone:702-778-4500
Mailing Address - Fax:702-778-3500
Practice Address - Street 1:74 N PECOS RD
Practice Address - Street 2:SUITE C
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7343
Practice Address - Country:US
Practice Address - Phone:702-778-4500
Practice Address - Fax:702-778-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20141465166261QD1600X, 261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech