Provider Demographics
NPI:1205479813
Name:CORE STRENGTH LLC
Entity type:Organization
Organization Name:CORE STRENGTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, LCADC
Authorized Official - Phone:702-686-4777
Mailing Address - Street 1:5532 S FORT APACHE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-7685
Mailing Address - Country:US
Mailing Address - Phone:702-478-4046
Mailing Address - Fax:
Practice Address - Street 1:5532 S FORT APACHE RD STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-7685
Practice Address - Country:US
Practice Address - Phone:702-478-4046
Practice Address - Fax:702-924-0630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-26
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNV20191569449OtherBUSINESS LICENSE