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Contact Information

AMATISTA
5398 NICKEL CREEK TRL
LAS VEGAS, NV89122-8317
 Phone: 702-812-4189
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for AMATISTA

NPI # 1972377232
LBN Legal business name AMATISTA
Authorized official WILLIAM GALLEGO - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/08/2023
Last updated 11/08/2023 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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