| Elevate Life | |
|
2605 Rainbow Glow St North Las Vegas NV 89030-3709 | |
| (702) 630-5009 | |
| Not Available |
| Full Name | Elevate Life |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2605 Rainbow Glow St, North Las Vegas, Nevada |
| Authorized Official Name and Position | Willie Pearl Jackson (OWNER) |
| Authorized Official Contact | 7026305009 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elevate Life 2605 Rainbow Glow St North Las Vegas NV 89030-3709 Ph: (702) 630-5009 | Elevate Life 2605 Rainbow Glow St North Las Vegas NV 89030-3709 Ph: (702) 630-5009 |
| NPI Number | 1033436787 |
|---|---|
| Provider Enumeration Date | 04/20/2010 |
| Last Update Date | 04/20/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033436787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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