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2340 Paseo Del Prado Ste D301 Las Vegas NV 89102-4342 | |
| (702) 255-0056 | |
| (702) 255-0076 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2340 Paseo Del Prado Ste D301, Las Vegas, Nevada |
| Authorized Official Name and Position | Sandal Arlillian Kelly (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7022550056 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2340 Paseo Del Prado Ste D301 Las Vegas NV 89102-4342 Ph: (702) 255-0056 | 2340 Paseo Del Prado Ste D301 Las Vegas NV 89102-4342 Ph: (702) 255-0056 |
| NPI Number | 1073768982 |
|---|---|
| Provider Enumeration Date | 11/19/2008 |
| Last Update Date | 07/26/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073768982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 02001 (Nevada) | Primary |
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