| Individual | |
|
8105 Hidden Quail Ave Las Vegas NV 89131-4647 | |
| (702) 203-2381 | |
| Not Available |
| Full Name | Individual |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 8105 Hidden Quail Ave, Las Vegas, Nevada |
| Authorized Official Name and Position | Josifina R Adams (OWNER) |
| Authorized Official Contact | 7022032381 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Individual 8105 Hidden Quail Ave Las Vegas NV 89131-4647 Ph: (702) 203-2381 | Individual 8105 Hidden Quail Ave Las Vegas NV 89131-4647 Ph: (702) 203-2381 |
| NPI Number | 1558663963 |
|---|---|
| Provider Enumeration Date | 11/17/2010 |
| Last Update Date | 11/17/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558663963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | E0613242008-1 (Nevada) | Primary |
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