Individual ProviderGilbert GrahamCounselorBehavioral Health & Social Service ProvidersPractice Address6171 W Charleston Blvd Bldg 14, Las Vegas, NV 89146-1126(702) 486-7664PECOS EnrollmentBased on the most recent information from CMS, provider Gilbert Graham 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 ID1912518002Provider TypeIndividualFull NameGraham, GilbertGenderMaleSole ProprietorYesEnumeration Date8/12/2020Last Updated8/12/2020Contact InformationPractice LocationPractice Address6171 W Charleston Blvd Bldg 14, Las Vegas, NV 89146-1126Phone(702) 486-7664FaxUnlisted FaxMailing LocationMailing Address6171 W Charleston Blvd Bldg 14, Las Vegas, NV 89146-1126PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer