Provider Demographics
NPI:1669818787
Name:SOUTHERN NEVADA VETERAN ASSOCIATION
Entity Type:Organization
Organization Name:SOUTHERN NEVADA VETERAN ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIAL SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-791-9000
Mailing Address - Street 1:121 N CIMARRON RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-3902
Mailing Address - Country:US
Mailing Address - Phone:702-400-7743
Mailing Address - Fax:
Practice Address - Street 1:121 N CIMARRON RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-3902
Practice Address - Country:US
Practice Address - Phone:702-400-7743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV19445286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital