Provenance Healthcare Llc

LBN: Provenance Healthcare Llc
Provenance Healthcare Llc is an health care organization with primary practice located at 5155 S Durango Dr Ste 103 , Las Vegas NV 89113-0175. The organization recently has only one registered license in Other Service Providers / Genetic Counselor, MS, which is considered as the primary health care specialty. Provenance Healthcare Llc can be contacted via phone (702) 478-2524, or through Black, Mark L via phone (702) 478-2524.

Contact Information

Primary practice address
5155 S Durango Dr Ste 103 Las Vegas NV 89113-0175
Phone: (702) 478-2524
Fax: (702) 735-9074
Website:
Map and Directions
Authorized official contact:
Name: Black, Mark L
Phone: (702) 478-2524

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Genetic Counselor, MS 170300000X OTHER Nevada

Profile Details

NPI number 1316322738
LBN Legal business name Provenance Healthcare Llc
DBA Doing business as
Authorized official Black, Mark L
Entity Organization
Organization subpart 1 No
Enumeration date Jul 27th, 2015
Last updated Jul 27th, 2015 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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