ALFORQUE TAN LLC NPI 1780096776

NPI Information

ALFORQUE TAN LLC is a mental health (including community mental health center) clinic center in Las Vegas, NV. ALFORQUE TAN LLC NPI is 1780096776. The provider is registered as an organization entity type.
The provider Is Doing Business As Icarepsychiatry.

The provider's business location address is:

6759 W CHARLESTON BLVD
SUITE 130
LAS VEGAS, NV
ZIP 89146-002
Phone: (702) 227-4165
Fax: (702) 227-7921

The provider's authorized official is Rhigel Alforque Tan .
The authorized official title is Sole Proprietor and has the following contact phone number (702) 227-4165.

The enumeration date for this NPI number is 5/23/2014 and was last updated on 6/30/2016.

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:

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