MEDICARE: THE MENTAL HEALTH CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1326556622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MENTAL HEALTH CENTER LLC

Provider Business Mailing Address
First Line	:	3053 W CRAIG RD STE E289
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-5124
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2465 REYNOLDS AVE STE 301
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-7296
Country	:	US
Telephone Number	:	702-916-0685
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED AGENT
Name	:	RAMON MOLINA
Credential	:
Telephone Number	:	702-916-0685

Provider Enumeration Date	:	01/21/2018
Last Update Date	:	01/21/2018

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Directions to “THE MENTAL HEALTH CENTER LLC ” Practice Location

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