Provider Demographics
NPI:1306549787
Name:TRUE HEALTH CLINIC LLC
Entity type:Organization
Organization Name:TRUE HEALTH CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MAYELIN
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-713-9714
Mailing Address - Street 1:2235 E FLAMINGO RD STE 153
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5198
Mailing Address - Country:US
Mailing Address - Phone:702-713-9714
Mailing Address - Fax:
Practice Address - Street 1:2235 E FLAMINGO RD STE 153
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5198
Practice Address - Country:US
Practice Address - Phone:702-713-9714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center