| Enrichminds Behavioral Health Llc | |
|
2975 S Rainbow Blvd Suite H #101 Las Vegas NV 89146 | |
| (702) 291-8468 | |
| Not Available |
| Full Name | Enrichminds Behavioral Health Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2975 S Rainbow Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Keisha Mae Tan (ADMIN) |
| Authorized Official Contact | 7252470388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enrichminds Behavioral Health Llc 2975 S Rainbow Blvd Suite H #101 Las Vegas NV 89146 Ph: (702) 291-8468 | Enrichminds Behavioral Health Llc 2975 S Rainbow Blvd Suite H #101 Las Vegas NV 89146 Ph: (702) 291-8468 |
| NPI Number | 1700644069 |
|---|---|
| Provider Enumeration Date | 03/11/2024 |
| Last Update Date | 07/29/2024 |
| Certification Date | 07/29/2024 |
| Medicare PECOS PAC ID | 3971048182 |
|---|---|
| Medicare Enrollment ID | O20240711004483 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700644069 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Eileen Michelle Salazar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346852712 PECOS PAC ID: 8921451949 Enrollment ID: I20240125004308 |
| Provider Name | Yolanda C King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144418898 PECOS PAC ID: 5294982211 Enrollment ID: I20240729003214 |
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