Provider Demographics
NPI:1831824481
Name:HEALTHCARE CONNECT 360, LLC
Entity type:Organization
Organization Name:HEALTHCARE CONNECT 360, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:QUESADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-644-9317
Mailing Address - Street 1:6671 S. LAS VEGAS BLVD
Mailing Address - Street 2:SUITE#210
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119
Mailing Address - Country:US
Mailing Address - Phone:847-345-2441
Mailing Address - Fax:847-474-9263
Practice Address - Street 1:6671 S. LAS VEGAS BLVD
Practice Address - Street 2:SUITE#210
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119
Practice Address - Country:US
Practice Address - Phone:847-345-2441
Practice Address - Fax:847-474-9263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty