|
| |
|
2152 Jasper Bluff St Unit 105 Las Vegas NV 89117-5977 | |
| (702) 327-2829 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Foster Care Agency |
| Location | 2152 Jasper Bluff St Unit 105, Las Vegas, Nevada |
| Authorized Official Name and Position | Christine Michelle Formica (DIRECTOR) |
| Authorized Official Contact | 7023272829 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2152 Jasper Bluff St Unit 105 Las Vegas NV 89117-5977 Ph: (702) 327-2829 | 2152 Jasper Bluff St Unit 105 Las Vegas NV 89117-5977 Ph: (702) 327-2829 |
| NPI Number | 1962717892 |
|---|---|
| Provider Enumeration Date | 08/16/2010 |
| Last Update Date | 08/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962717892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 5789-C (Nevada) | Secondary |
| 253J00000X | Foster Care Agency | 5789-C (Nevada) | Primary |
Creating Empowerment Corporation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4773 Madrid Ridge Ct, Las Vegas, NV 89129 Phone: 702-656-9890 Fax: 702-656-9152 | |
No Obstacles Mental Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 8565 S Eastern Ave, Suite 174, Las Vegas, NV 89123 Phone: 702-462-3082 | |
The Village Behavior Health Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6330 Mcleod Dr, Suite 4&5, Las Vegas, NV 89120 Phone: 702-437-0341 | |
Journey Community Health Organization Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6512 N Decatur Blvd, Suite 130-114, Las Vegas, NV 89131 Phone: 702-830-2481 Fax: 702-664-0648 |