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3450 E Russell Rd Ste 105l Las Vegas NV 89120-2201 | |
| (702) 714-1648 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 3450 E Russell Rd Ste 105l, Las Vegas, Nevada |
| Authorized Official Name and Position | Robin Mason (CEO) |
| Authorized Official Contact | 7027141648 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3450 E Russell Rd Ste 105l Las Vegas NV 89120-2201 Ph: (702) 810-9226 | 3450 E Russell Rd Ste 105l Las Vegas NV 89120-2201 Ph: (702) 714-1648 |
| NPI Number | 1003180647 |
|---|---|
| Provider Enumeration Date | 02/29/2012 |
| Last Update Date | 08/19/2021 |
| Certification Date | 08/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003180647 | NPI | - | NPPES |
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