Provider Demographics
NPI:1528897220
Name:GAY AND LESBIAN COMMUNITY CENTER OF SOUTHERN NEVADA INC
Entity type:Organization
Organization Name:GAY AND LESBIAN COMMUNITY CENTER OF SOUTHERN NEVADA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LEANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-476-9436
Mailing Address - Street 1:921 LAS VEGAS BLVD S
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-6840
Mailing Address - Country:US
Mailing Address - Phone:702-213-4023
Mailing Address - Fax:
Practice Address - Street 1:921 LAS VEGAS BLVD S
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-6840
Practice Address - Country:US
Practice Address - Phone:702-476-9436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GAY AND LESBIAN COMMUNITY CENTER OF SOUTHERN NEVADA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-31
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty