Healthcare Provider Details

I. General information

NPI: 1750960043
Provider Name (Legal Business Name): URBAN HEALTHY MINDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 S EASTERN AVE STE 150
HENDERSON NV
89052-5576
US

IV. Provider business mailing address

11500 S EASTERN AVE STE 150
HENDERSON NV
89052-5576
US

V. Phone/Fax

Practice location:
  • Phone: 702-540-7671
  • Fax: 702-552-7138
Mailing address:
  • Phone: 702-540-7671
  • Fax: 702-552-7138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOANNA GHANEM
Title or Position: MANAGING MEMBER
Credential:
Phone: 702-540-7671