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Contact Information

FORMA INTEGRATED HEALTHCARE
2655 S RAINBOW BLVD STE 410
LAS VEGAS, NV89146-5100
 Phone: 702-726-9722
 Fax: 702-906-0067
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
 

Family

103TF0000X 62 Psychologist, Clinical
 

Family

363LF0000X 50 Nurse Practitioner
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Wound Care

163WW0000X
Indicates primary specialty

NPI Profile & details for FORMA INTEGRATED HEALTHCARE

NPI Number 1023964657
LBN Legal business name FORMA INTEGRATED HEALTHCARE
Authorized official ANN UGANIZA - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 03/06/2026
Last updated 03/09/2026 - About 3 months 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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