| Optimal Mental Health Clinic | |
|
4760 S Pecos Rd Las Vegas NV 89121-6038 | |
| (725) 200-1050 | |
| Not Available |
| Full Name | Optimal Mental Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 4760 S Pecos Rd, Las Vegas, Nevada |
| Authorized Official Name and Position | Munachi Ezenwata (NURSE PRACTITIONER) |
| Authorized Official Contact | 7252001050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimal Mental Health Clinic Po Box 30771 Las Vegas NV 89173-0771 Ph: () - | Optimal Mental Health Clinic 4760 S Pecos Rd Las Vegas NV 89121-6038 Ph: (725) 200-1050 |
| NPI Number | 1487419057 |
|---|---|
| Provider Enumeration Date | 02/14/2024 |
| Last Update Date | 02/15/2024 |
| Certification Date | 02/15/2024 |
| Medicare PECOS PAC ID | 2668814179 |
|---|---|
| Medicare Enrollment ID | O20240530000237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487419057 | NPI | - | NPPES |
| Provider Name | Munachi Queena Ezenwata |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194356733 PECOS PAC ID: 0749611598 Enrollment ID: I20200511001788 |
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