Healthcare Provider Details

I. General information

NPI: 1992001218
Provider Name (Legal Business Name): PREMIER BEHAVIORAL HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2011
Last Update Date: 02/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 S JONES BLVD STE D3
LAS VEGAS NV
89103-3370
US

IV. Provider business mailing address

4425 S JONES BLVD STE D3
LAS VEGAS NV
89103-3370
US

V. Phone/Fax

Practice location:
  • Phone: 702-685-0674
  • Fax: 702-566-4575
Mailing address:
  • Phone: 702-685-0674
  • Fax: 702-566-4575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number01030
License Number StateNV

VIII. Authorized Official

Name: DAWN SARNA
Title or Position: PRESIDENT
Credential: MFT
Phone: 702-685-0674