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6857 W Charleston Blvd Las Vegas NV 89117-1600 | |
| (702) 586-3050 | |
| (702) 586-3062 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6857 W Charleston Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Mitriece Amelia Sumbry (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 7025863050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6883 W Charleston Blvd Ste A Las Vegas NV 89117-1645 Ph: (702) 586-3050 | 6857 W Charleston Blvd Las Vegas NV 89117-1600 Ph: (702) 586-3050 |
| NPI Number | 1770960874 |
|---|---|
| Provider Enumeration Date | 04/28/2015 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770960874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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