Wheatley De Forge LLC

NPI #1104326438 in Las Vegas, Nevada

Provider Information

NPI Number: 1104326438
Entity Type: Organization
Organization Name: Wheatley De Forge LLC
Subpart: Yes (part of a larger organization)
Parent Organization: NV20161161415
Primary Specialty: Social Worker - Clinical
Enumeration Date: Feb 13, 2018
Last Updated: Dec 26, 2024

Practice Location

Address: 6900 WESTCLIFF DR STE 504
City: Las Vegas
State: Nevada
ZIP Code: 89145-0198
Phone: (702) 778-9875

Authorized Official

Name: LEONARD EUGENE DEFORGE
Title: ADMIN
Phone: (027) 778-9875

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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