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2725 S Jones Blvd Suite 109 Las Vegas NV 89146-5667 | |
| (702) 517-1519 | |
| (702) 829-2876 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2725 S Jones Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Raelara Tilden (PRESIDENT/CLINICAL SUPERVISOR) |
| Authorized Official Contact | 7025171519 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1355 Silver Sierra St Las Vegas NV 89128-2159 Ph: (702) 517-1519 | 2725 S Jones Blvd Suite 109 Las Vegas NV 89146-5667 Ph: (702) 517-1519 |
| NPI Number | 1851837801 |
|---|---|
| Provider Enumeration Date | 01/15/2017 |
| Last Update Date | 01/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851837801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MI0591 (Nevada) | Primary |
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