LEGACY THERAPEUTIC CENTER LLC (NPI# 1144738188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144738188 |
| Entity Type | Organization |
| Organization Name | LEGACY THERAPEUTIC CENTER LLC |
| Practice Address |
4530 S Eastern Ave Ste 1 Las Vegas NV 89119-6181 |
| Practice Telephone | 7724805611 |
| Mailing Telephone | 7724805611 |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2018-01-11 |
| Authorized Official Name | MICHAEL HARRISON (OWNER) |
| Authorized Official Telephone | 7724805611 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
4530 S EASTERN AVE STE 1 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89119-6181 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992714430 | David M Fadell | Orthopaedic Surgery | 4530 S Eastern Ave Ste 1, Las Vegas, NV 89119-6181 | 2006-08-05 |
| 1992278527 | Ernest Michael Sheppard | Rehabilitation Counselor | 4530 S Eastern Ave Ste 1, Las Vegas, NV 89119-6181 | 2019-01-07 |
| 1972076768 | Alesia Harper | Rehabilitation Counselor | 4530 S Eastern Ave Ste 1, Las Vegas, NV 89119-6181 | 2019-01-04 |
| 1912478173 | Legacy Life Center LLC | Counselor | 4530 S Eastern Ave Ste 1, Las Vegas, NV 89119-6181 | 2018-12-16 |
| 1699934927 | Hand Surgery Specialists of Nevada Young LLP | Orthopaedic Surgery | 4530 S Eastern Ave Ste 1, Las Vegas, NV 89119-6181 | 2008-06-02 |
| 1356427249 | Colby P Young M D P C | Orthopaedic Surgery | 4530 S Eastern Ave Ste 1, Las Vegas, NV 89119-6181 | 2006-10-31 |
| 1366552176 | Jedediah W Jones | Orthopaedic Surgery | 4530 S Eastern Ave Ste 1, Las Vegas, NV 89119-6181 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669089298 | Jennifer Chavon Cruse | Technician | [email protected], 1775 East Tropicana Avenue 16-b, Las Vegas, NV 89119 | 2020-09-28 |
| 1063024214 | Rosa Isela Martinez Gonzalez | Technician | 4324 S. Eastern Ave. Ste. B, Las Vegas, NV 89119 | 2020-08-19 |
| 1720697980 | Christian Scott | Social Worker | 4055 Spencer St #118, Las Vegas, NV 89119 | 2020-07-23 |
| 1245867159 | Starfruit Holdings, LLC | Skilled Nursing Facility | 4375 S Eastern Ave, Paradise, NV 89119 | 2020-03-23 |
| 1215562376 | Phyllis Eberechukwu Hunt | Adult Companion | 5160 Tamarus St Appt 17, Las Vegas, NV 89119 | 2020-03-10 |
| 1841832581 | Legna Carrillo | Adult Companion | 4325 South Bruce St Appt 63, Las Vegas, NV 89119 | 2019-10-15 |
| 1104468339 | Alma Leticia Salazar | Home Health Aide | Safe At Home, LLC, 1775 E. Tropicana Ave. Suit 16-b, Las Vegas, NV 89119 | 2019-10-09 |
| 1083260046 | Araceli Rosas Vargas | Technician | 5160 S. Eastern Ave, Suite E, Las Vegas, NV 89119 | 2019-08-15 |
| 1376197707 | Bristure Clayton | Technician | Safe At Home LLC, 1775 E Tropicana Ave Ste 16, Las Vegas, NV 89119 | 2019-07-24 |
| 1457904534 | Carmen Laura Gonzalez Valenzuela | Chore Provider | 6725-1 S. Eastern Ave, Las Vegas, NV 89119 | 2019-07-18 |
| Find all providers in zip 89119 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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|---|---|---|---|---|
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| 1306450978 | Super Life Codes Foundation | Clinic/Center | 4276 Spring Mountain Rd Unit 214, Las Vegas, NV 89102-8781 | 2020-09-01 |
| 1194335554 | New Leaf Wellness & Behavioral Health LLC | Clinic/Center | 3430 E Flamingo Rd Ste 244, Las Vegas, NV 89121-5020 | 2020-07-31 |
| 1700495884 | Fmt Behavioral Health Services | Clinic/Center | 4170 S Decatur Blvd Ste A6, Las Vegas, NV 89103-5862 | 2020-07-24 |
| 1962011049 | Nevada Psychotherapy Practice LLC | Clinic/Center | 8766 S Maryland Pkwy Ste 105, Las Vegas, NV 89123-6701 | 2020-07-24 |
| 1346858024 | Fairclough Consulting Services, LLC | Clinic/Center | 9224 Tudor Park Pl, Las Vegas, NV 89145-8726 | 2020-07-17 |
| 1841818457 | Wellness Foundation | Clinic/Center | 9850 S Maryland Pkwy # 5-371, Las Vegas, NV 89183-7146 | 2020-07-09 |
| 1225656358 | Behavioral and Health Management LLC | Clinic/Center | 1500 E Tropicana Ave Ste 155, Las Vegas, NV 89119-6516 | 2020-07-06 |
| 1366069312 | Holding Onto Hope L.l.c | Clinic/Center | 2725 W Wigwam Ave Apt 2108, Las Vegas, NV 89123-6611 | 2020-06-25 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.