Provider Demographics
NPI:1710499264
Name:FIRST PERSON CARE CLINIC
Entity Type:Organization
Organization Name:FIRST PERSON CARE CLINIC
Other - Org Name:FIRST PERSON COMPLETE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROXANA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-380-8118
Mailing Address - Street 1:1200 S 4TH ST STE 111
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-1046
Mailing Address - Country:US
Mailing Address - Phone:702-380-8118
Mailing Address - Fax:702-380-2929
Practice Address - Street 1:200 E HORIZON DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-8033
Practice Address - Country:US
Practice Address - Phone:702-380-8118
Practice Address - Fax:702-380-2929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-24
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 1041C0700X, 207RI0200X, 207V00000X, 208000000X, 261QF0050X, 261QM1300X, 261QP2300X
NV251S00000X, 261QD0000X, 261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1710499264Medicaid