1 Love Wellness Society LLC

Organization Active NPI Community/Behavioral Health Agency · Las Vegas, NV

NPI 1235677477 · NPPES record last updated Sep 3, 2021

Key facts

NPI
1235677477
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
NV20161704135 (NV)
Legal business name
1 LOVE WELLNESS SOCIETY LLC
Practice address
5940 S Rainbow Blvd Ste 213
RM 1014
Las Vegas, NV 89118-2506
Phone
(562) 714-2146
NPI assigned
Feb 8, 2017
Organization subpart
No

Authorized official

Name
Denise Madison
Title
Owner
Phone
(562) 714-2146

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NV

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210922000917 NV Part B Supplier - Clinic/Group Practice 4789081530 Receives reassigned benefits from 4 practitioners
Practice locations: Las Vegas, NV

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NV20161704135 NV Yes
Mental Illness Community Based Residential Treatment Facility 320800000X NV20161704135 NV

Addresses

Primary practice location

5940 S Rainbow Blvd Ste 213
RM 1014
Las Vegas, NV 89118-2506

Mailing address

5940 S Rainbow Blvd Ste 213
RM 1014
Las Vegas, NV 89118-2506
Phone (562) 714-2146

Other practice location 1

6719 Sugarbird Ct
North Las Vegas, NV 89084-2227
Phone (562) 714-2146

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Community/Behavioral Health Agency in Nevada

Sources for this page

Verify at the official NPI Registry.