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EVERSIDE HEALTH LLC NPI 1407481997


NPI Information

NPI: 1407481997
Provider Name: EVERSIDE HEALTH, LLC

Doing Business As: ACTIVATE HEALTHCARE

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 29D2159215

Address:
911 N BUFFALO DR UNIT 113
LAS VEGAS, NV
ZIP 89128
Phone: (702) 960-4415
Get Directions

EVERSIDE HEALTH, LLC is a clinic center in Las Vegas, NV. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). EVERSIDE HEALTH, LLC NPI is 1407481997. The provider is registered as an organization entity type.
The provider Is Doing Business As Activate Healthcare.

The provider's business location address is:

911 N BUFFALO DR UNIT 113
LAS VEGAS, NV
ZIP 89128-380
Phone: (702) 960-4415

The provider's authorized official is Jill Johnson Patton .
The authorized official title is Director Of Risk Management and has the following contact phone number (704) 936-5546.

The CLIA number assigned to this NPI record is 29D2159215 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/5/2020 and was last updated on 8/11/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/CenterYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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