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840 S Rancho Dr Ste 4-903 Las Vegas NV 89106-3837 | |
| (702) 440-8840 | |
| (866) 518-0781 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 840 S Rancho Dr Ste 4-903, Las Vegas, Nevada |
| Authorized Official Name and Position | Timothy Benjamin James Jeider (OWNER) |
| Authorized Official Contact | 7024408430 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
840 S Rancho Dr Ste 4-903 Las Vegas NV 89106-3837 Ph: (702) 440-8840 | 840 S Rancho Dr Ste 4-903 Las Vegas NV 89106-3837 Ph: (702) 440-8840 |
| NPI Number | 1295317659 |
|---|---|
| Provider Enumeration Date | 04/26/2021 |
| Last Update Date | 12/15/2022 |
| Certification Date | 12/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295317659 | NPI | - | NPPES |
| 1902149248 | Medicaid | NV |
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