Provider Demographics
NPI:1619523677
Name:NADHC AT EASTERN, INC
Entity Type:Organization
Organization Name:NADHC AT EASTERN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:V
Authorized Official - Last Name:VITO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:702-319-4600
Mailing Address - Street 1:2008 S. JONES BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-3151
Mailing Address - Country:US
Mailing Address - Phone:702-319-4600
Mailing Address - Fax:702-319-4604
Practice Address - Street 1:8695 S. EASTERN AVE.
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123
Practice Address - Country:US
Practice Address - Phone:702-778-1234
Practice Address - Fax:702-778-1223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care