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
-
Dominique Roumain, MSW, LCSW
-
Martin Louis Apt, PMHNP
-
Sean Elder, APRN
-
Denise Madison, M.S. MFT I
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Las Vegas, NV · Community/Behavioral Health Agency in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.