| Beautiful Mind | |
|
3841 W Charleston Blvd Ste 202 Las Vegas NV 89102-1858 | |
| (702) 808-0011 | |
| Not Available |
| Full Name | Beautiful Mind |
|---|---|
| Speciality | Social Worker |
| Location | 3841 W Charleston Blvd Ste 202, Las Vegas, Nevada |
| Authorized Official Name and Position | Jessica Tinte Erfe (MANAGER MEMBER) |
| Authorized Official Contact | 7027049611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beautiful Mind 3841 W Charleston Blvd Ste 202 Las Vegas NV 89102-1858 Ph: (702) 808-0011 | Beautiful Mind 3841 W Charleston Blvd Ste 202 Las Vegas NV 89102-1858 Ph: (702) 808-0011 |
| NPI Number | 1356940639 |
|---|---|
| Provider Enumeration Date | 10/19/2020 |
| Last Update Date | 05/14/2024 |
| Certification Date | 05/14/2024 |
| Medicare PECOS PAC ID | 9032550199 |
|---|---|
| Medicare Enrollment ID | O20240507004408 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356940639 | NPI | - | NPPES |
| Provider Name | Victor S Ingram |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043745557 PECOS PAC ID: 1557795697 Enrollment ID: I20191226002130 |
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