Provider Demographics
NPI:1184953986
Name:NEVADA HEARING & BALANCE CENTER LLC
Entity type:Organization
Organization Name:NEVADA HEARING & BALANCE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LAYNE
Authorized Official - Last Name:LUEKENGA
Authorized Official - Suffix:JR
Authorized Official - Credentials:AUD
Authorized Official - Phone:435-688-8991
Mailing Address - Street 1:2461 W HORIZON RIDGE PKWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5943
Mailing Address - Country:US
Mailing Address - Phone:702-896-0031
Mailing Address - Fax:702-896-1044
Practice Address - Street 1:2461 W HORIZON RIDGE PKWY
Practice Address - Street 2:SUITE 130
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5943
Practice Address - Country:US
Practice Address - Phone:702-896-0031
Practice Address - Fax:702-896-1044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-187231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty