Look up the most recent NPI and PECOS records

Lifestyle Overhaul, Llc

Counselor

Behavioral Health & Social Service Providers

98 E Lake Mead Pkwy Ste 201, Henderson, NV 89015-6443

PECOS Enrollment

Based on the most recent information from CMS, provider Lifestyle Overhaul, Llc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1821628199
Provider Type
Organization
Full Name
Lifestyle Overhaul, Llc

Subpart
No
Enumeration Date
1/24/2020
Last Updated
4/21/2021

Contact Information

Practice Location

98 E Lake Mead Pkwy Ste 201, Henderson, NV 89015-6443

(702) 433-3038

Unlisted Fax

Mailing Location

98 E Lake Mead Pkwy Ste 201, Henderson, NV 89015-6443

(702) 433-3038

Unlisted Fax

Authorized Official

Johnson, Claudia (Professional Clinical Counselor)

(708) 752-3361

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 101YP2500X	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 101YS0200X	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer

Lifestyle Overhaul, Llc

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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