Healthcare Provider Details

I. General information

NPI: 1740042365
Provider Name (Legal Business Name): CMP SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 01/29/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2960 W HORIZON RIDGE PKWY
HENDERSON NV
89052-4666
US

IV. Provider business mailing address

PO BOX 752003
LAS VEGAS NV
89136-2003
US

V. Phone/Fax

Practice location:
  • Phone: 702-405-8088
  • Fax:
Mailing address:
  • Phone: 702-405-8088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JAMIE BROWN
Title or Position: CFO
Credential:
Phone: 702-405-8088