NPI 1548627961

Stellar Living Enterprises , INC

Organisation Exclusive Provider Organization Las Vegas, NV

Practice location

Address: 2191 Pinetop Ln Unit # 108, Las Vegas, NV 89119-7812
Phone: (702) 806-1380

Authorised official

Name: Dexter Desha Weathers
Title: Director
Phone: (702) 806-1380

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

Other Exclusive Provider Organization providers in Nevada →

Registry record

NPI: 1548627961
Entity type: Organization
NPI issued: 16 Jan 2016
Record last updated: 16 Jan 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.