| Mended | |
|
6797 Conquistador St Las Vegas NV 89149-1315 | |
| (702) 551-9380 | |
| Not Available |
| Full Name | Mended |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 6797 Conquistador St, Las Vegas, Nevada |
| Authorized Official Name and Position | Kelli Mosley (TREASURER) |
| Authorized Official Contact | 7025519380 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mended 6720 N Hualapai Way Ste 145-255 Las Vegas NV 89149-1371 Ph: (702) 551-9380 | Mended 6797 Conquistador St Las Vegas NV 89149-1315 Ph: (702) 551-9380 |
| NPI Number | 1629601026 |
|---|---|
| Provider Enumeration Date | 02/14/2020 |
| Last Update Date | 02/14/2020 |
| Certification Date | 02/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629601026 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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