| N/a | |
|
2920 S Jones Blvd Ste 110 Las Vegas NV 89146-5642 | |
| (702) 381-6525 | |
| Not Available |
| Full Name | N/a |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2920 S Jones Blvd Ste 110, Las Vegas, Nevada |
| Authorized Official Name and Position | Miko Baker (OWNER) |
| Authorized Official Contact | 7025024045 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| N/a 2920 S Jones Blvd Ste 110 Las Vegas NV 89146-5642 Ph: (702) 381-6525 | N/a 2920 S Jones Blvd Ste 110 Las Vegas NV 89146-5642 Ph: (702) 381-6525 |
| NPI Number | 1316472277 |
|---|---|
| Provider Enumeration Date | 04/27/2017 |
| Last Update Date | 04/27/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316472277 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | NV20171271300 (Nevada) | Primary |
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