Individual ProviderRivera VivaoCounselorBehavioral Health & Social Service ProvidersPractice Address6171 W Charleston Blvd Bldg 14, Las Vegas, NV 89146-1126(702) 486-7664(702) 493-6091PECOS EnrollmentBased on the most recent information from CMS, provider Rivera Vivao does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1740842947Provider TypeIndividualFull NameVivao, RiveraGenderMaleSole ProprietorNoEnumeration Date7/8/2019Last Updated1/23/2020Contact InformationPractice LocationPractice Address6171 W Charleston Blvd Bldg 14, Las Vegas, NV 89146-1126Phone(702) 486-7664FaxUnlisted FaxMailing LocationMailing Address1770 N Green Valley Pkwy Apt 3912, Henderson, NV 89074-5839Phone(702) 493-6091FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerCode106S00000XDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer