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4440 S Maryland Pkwy Suite 101 Las Vegas NV 89119-7527 | |
| (702) 655-7466 | |
| (702) 642-5722 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 4440 S Maryland Pkwy, Las Vegas, Nevada |
| Authorized Official Name and Position | Ebony A Danford (PROJECT MANAGER) |
| Authorized Official Contact | 7026557466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
800 N Rainbow Blvd Ste 158 Las Vegas NV 89107-1189 Ph: (702) 655-7466 | 4440 S Maryland Pkwy Suite 101 Las Vegas NV 89119-7527 Ph: (702) 655-7466 |
| NPI Number | 1528395381 |
|---|---|
| Provider Enumeration Date | 11/14/2009 |
| Last Update Date | 08/23/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528395381 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (Nevada) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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