Healthcare Provider Details
I. General information
NPI: 1164642070
Provider Name (Legal Business Name): SOUTHERN NEVADA ADULT MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1650 COMMUNITY COLLEGE DRIVE
LAS VEGAS NV
89146
US
IV. Provider business mailing address
6161 W CHARLESTON BLVD
LAS VEGAS NV
89146-1126
US
V. Phone/Fax
- Phone: 702-486-4400
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 283Q00000X |
| Taxonomy | Psychiatric Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LORI
JUDGE
Title or Position: ADMINISTRATIVE SERVICES OFFICER III
Credential:
Phone: 702-486-6099