Provider Demographics
NPI:1962227454
Name:ENLIVEN INFUSION AND WELLNESS CLINIC LLC
Entity type:Organization
Organization Name:ENLIVEN INFUSION AND WELLNESS CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:702-686-8907
Mailing Address - Street 1:350 FALCON RIDGE PKWY STE 204
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:NV
Mailing Address - Zip Code:89027-8879
Mailing Address - Country:US
Mailing Address - Phone:702-686-8907
Mailing Address - Fax:
Practice Address - Street 1:350 FALCON RIDGE PKWY STE 204
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-8879
Practice Address - Country:US
Practice Address - Phone:702-686-8907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENLIVEN INFUSION AND WELLNESS CLINIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy