Healthcare Provider Details

I. General information

NPI: 1851002422
Provider Name (Legal Business Name): HELIOS MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 12/05/2022
Certification Date: 12/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2628 IRONSIDE DR
LAS VEGAS NV
89108-4466
US

IV. Provider business mailing address

2628 IRONSIDE DR
LAS VEGAS NV
89108-4466
US

V. Phone/Fax

Practice location:
  • Phone: 702-573-2011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ISADORIS OTANO GUTIERREZ
Title or Position: OWNER
Credential:
Phone: 702-912-9886