Provider Demographics
NPI:1891585071
Name:SAMSARA ADDE
Entity type:Organization
Organization Name:SAMSARA ADDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:GEOVANI
Authorized Official - Last Name:PEREZ MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-713-4501
Mailing Address - Street 1:83 PARKER RANCH DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-2613
Mailing Address - Country:US
Mailing Address - Phone:702-713-4501
Mailing Address - Fax:
Practice Address - Street 1:4660 S EASTERN AVE STE 203A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6139
Practice Address - Country:US
Practice Address - Phone:702-713-4501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health