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NPI Code Detail

MEDICARE: GRAND DESERT PSYCHIATRIC SERVICES

MEDICARE: GRAND DESERT PSYCHIATRIC SERVICES
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
1101YM0800XMental Health CounselorAPRN001638NV

General Provider Information

NPI Number : 1831586262
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRAND DESERT PSYCHIATRIC SERVICES
Provider Business Mailing Address
First Line : 2021 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-3137
Country : US
Telephone Number : 702-202-0099
Fax Number :
Provider Business Practice Location Address
First Line : 2021 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-3137
Country : US
Telephone Number : 702-202-0099
Fax Number :
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : DR. MATTHEW OKEKE
Credential : MD
Telephone Number : 702-202-0099
Provider Enumeration Date : 04/23/2015
Last Update Date : 04/23/2015

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Directions to “GRAND DESERT PSYCHIATRIC SERVICES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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