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6771 West Charleston Blvd. Suite C Las Vegas NV 89146 | |
| (702) 467-1377 | |
| (702) 823-4781 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6771 West Charleston Blvd., Las Vegas, Nevada |
| Authorized Official Name and Position | Ryan Brendon (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7024671377 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 370724 Las Vegas NV 89137 Ph: (702) 467-1377 | 6771 West Charleston Blvd. Suite C Las Vegas NV 89146 Ph: (702) 467-1377 |
| NPI Number | 1407158942 |
|---|---|
| Provider Enumeration Date | 12/02/2010 |
| Last Update Date | 04/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407158942 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | NV 20101552416 (Nevada) | Primary |
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