Provider Demographics
NPI:1124731401
Name:CELESTIAL HEALTH SOLUTIONS
Entity type:Organization
Organization Name:CELESTIAL HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-569-7244
Mailing Address - Street 1:222 S RAINBOW BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-5356
Mailing Address - Country:US
Mailing Address - Phone:702-500-1728
Mailing Address - Fax:702-707-8921
Practice Address - Street 1:222 S RAINBOW BLVD STE 206
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-5356
Practice Address - Country:US
Practice Address - Phone:702-500-1728
Practice Address - Fax:702-707-8921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty